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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 /> SHOP N GO 3 4511 PACIFIC AVE, STOCKTON February 25, 2020 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 118 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the "Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> OBSERVATION: The Underground Storage Tank Statement of Understanding and Compliance Form was not found <br /> in CERS. <br /> REGULATION GUIDANCE: This form must be uploaded to the California Environmental Reporting System (CERS). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS) at <br /> http://cers.calepa.ca.gov and upload the Underground Storage Tank Statement of Understanding and Compliance <br /> Form for this facility. <br /> This is a minor violation. <br /> 121 CCR 2712(f) Failure to implement corrections and submit written response within 30 days of receiving the report. <br /> OBSERVATION: An inspection was last done on 02/05/2019 and an inspection report was issued identifying <br /> information to be submitted to bring this site into compliance. This information was required to be submitted by <br /> March 7, 2019. This information has not been received resulting in a non-compliant status for this facility. <br /> REGULATION GUIDANCE: An operator that receives an inspection report shall have 30 days to implement the <br /> corrections specified in the inspection report and comply with permit conditions. The corrective action shall include <br /> all of the recommendations made in the report. The operator shall submit a written response that includes a <br /> statement documenting corrective actions taken or proposing corrective actions which will be taken. <br /> CORRECTIVE ACTION: Ensure that a written response documenting corrective actions taken or proposed is <br /> submitted and all corrections implemented within 30 days of receiving an inspection report. <br /> This is a Class II violation. <br /> 124 CCR 2637.2(d&e), 2665(a&b)"Overfill Prevention Equipment Inspection Report Form" not submitted within 30 days <br /> of inspection. <br /> OBSERVATION: Overfill prevention testing was performed on 02/5/2019 test results not submitted to EHD. <br /> REGULATION GUIDANCE: Atest report has not been submitted to the EHD or the California Environmental <br /> Reporting System (CERS). 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 /> FA0002480 PR0231216 SCO01 02/25/2020 <br /> EHD 23-01 Rev.9/20/2019 Page 5 of 7 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.sjcehd.com <br />