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Page 1 of 7 San Joaquin County IV Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: AM PM HAMMER/15 FOOD #83113 Facility Phone: 209 474-9125 Data: Mav 07 2015 Facility Address: 3250 W HAMMER LN STOCKTON CA 95209 CERS ID: 10180825 Inspection Contact: Wes Parkinson Title: Owner Phone: 209 474-9125 Inspection Type: ROUTINE INSPECTION - Operatinq Permit Program: 2361 - UST FACILITY Consent For: InsiDection Photos Consent Given By: Sampling Wes Parkinson Owner Service Technician Onsite Exp. Date: Isaac Anderson 06/22/2016 Designated Operator: James Flowers Exp. Date: 01/08/2017 Service Technician Manufacturer's Training: Veeder-Root Level 4 09/26/16 VMI Tester 03/19/15 R fomia ode of Regulations H = Health and Safety Code CFR = Code of Federal Regulations = ali V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284 No permit to operate ■ V ❑ R ❑ COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292.2 Current financial responsibility documents not submitted ❑ V ❑ R ❑ COS 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current ❑ V ❑ R ❑ COS 105 HSC 25286(c) Current BOE number not submitted ❑ V ❑ R ❑ COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD ■ V ■ R ❑ COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■ V ❑ R ❑ COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ R ❑ COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑ V ❑ R ❑ COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑ V ❑ R ❑ COS 112 HSC 25284.2 Failed to test spill containers annually ❑ V ❑ R ❑ COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ❑ V ❑ R ❑ COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑ V ❑ R ❑ COS 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days ■ V ■ R ❑ COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1 000'of a public well ❑ V ❑ R ❑ COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑ V ❑ R ❑ COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ❑ V ❑ R ❑ COS 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑ V ❑ R ❑ COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑ V ❑ R ❑ COS 122 HSC 25299 Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 123 CCR 2661 Permit to repair UST system not obtained ❑ V ❑ R ❑ COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS Received by (initial): Inspector: STACY RIVERA, Senior REHS CO(209) Phone: 468-3440 Date: 05/07/2015 Page 1 of 7