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A J OA U I Environmental Health Department <br /> COUNTY <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CITY GAS & LIQUOR 1 16470 CAMBRIDGE ST, LATHROP December 22, 2020 <br /> Single-Walled Non-Pressurized Piping <br /> 404 CCR 2643(,),2661(f) Failure to conduct 0.1 gph test on single-walled gravity piping biennially or post repair(pre-1984) ❑V ❑R ❑COS <br /> Other Violations <br /> 2010 1 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 107 HSC 25292.2; CCR 2711(a)(11) Failure to submit and maintain complete and current financial responsibility <br /> documents. <br /> 1) OBSERVATION: The current Financial responsibility documents have not been submitted to the EHD. The most <br /> recent financial responsibility documents in CERS are dated 12/17/2019. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS) at <br /> http://cers.calepa.ca.gov/, and upload the required documents. <br /> This was corrected on site. <br /> 2) OBSERVATION: Current financial responsibility documents were not found on site. <br /> REGULATION GUIDANCE: A copy of current financial responsibility documents are required to be maintained on <br /> site. <br /> CORRECTIVE ACTION: Immediately obtain a copy of the facility's financial responsibility documents and maintain a <br /> copy on site. <br /> This was corrected on site. <br /> This is a minor violation. <br /> 118 CCR 2637.2(d&e), 2665(a&b) Failure to submit the "Overfill Prevention Equipment Inspection Report Form"within <br /> 30 days. <br /> OBSERVATION: Overfill prevention testing was performed on 12/27/2018. Atest report has not been submitted to <br /> the EHD or the California Environmental Reporting System (CERS). <br /> REGULATION GUIDANCE: A copy of the 'Overfill prevention Testing Report Form' must be submitted within 30 <br /> days of the test. <br /> CORRECTIVE ACTION: Immediately provide this report to the EHD. <br /> This is a minor violation. <br /> FA0000185 PR0231532 SCO01 12/22/2020 <br /> EHD 23-01 Rev.9/16/2020 Page 4 of 6 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />