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'7-0 1 -7 6 ( RECENM k"M v 5 7- SAWJOANIN JAN 16 2019nvironmental Health Department -.mCUNT"Y. ,.__. Greotness ENVIRONMENTAL HEAL TF� Facility FacWdy Phone. Date: CHEVRON USA#201761` {209)825-0714 January 04,2018 Fac Add CERS 10: 1103 S MAIN ST,MANTECA,CA 95337 10181653 Ins on contact =Manager : Phone: Loisa Verduz (209)825-0174 In-s on Ty : P ram: ROUTINE INSPECTION-Operating Permit ::12361 -UST FACILITY Consent For. Consent Given 10 Inspection ®Photos ®Samples Laisa Verduzco,Manager Service Technician Onsite: Exp.Date, Designated Operator. Exp.Data: Jarrod Cooke 0410672019 Elijah Pendergraft 10614/2019 Service Technician Manufacturer's Training: Veeder Root,05609117 VMI,02624119 CCR=CWdofniao! tans HSC=Hearth and g afety Ceuta CFR- ode of Federal Regulations V m vidaWn R=Repeat violation COS Cor ed an sda 101 HSC 25284 Failure to obtain a valid permit to operate from the EHD including but not limited to unpaid s o V o R u COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system u V a R o COS 103 HSC 25292.2,25299 30 Current financial responsibility documents not submitted OV ❑R c COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V u R o COS 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan -,V a R o COS 2634(d) 106 CCR 2632(d)(2), Failed to have an approved UST response plan o V o R o COS 2634(e) 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or faded to completely show where monitoring is performed o V ❑R o COS 108 CCR 2637(0,2638(e) Failed to notify the EHD 48 hours prior to conducting testing OV a R o COS 109 CCR 2637 Failed to test secondary containment OV a R o COS 110 CCR 2637(e) Failed to submit secondary containment test rein 30 days a V o R o COS 111 CCR 2638(a) Failed to test monitoring and leek detection equipment annually o V o R o COS 112 HSC 25284.2 Failed to test spill containers annually o V a R n COS 113 CCR 2638(d) Failed to submit monitoring system certification test within 30 days OV o R o COS 114 CCR 2636(f) Failed to perform 0 1 gph annual lure test for pressurized piping without led safe or shut down o V o R o COS 115 CCR 2715(a) Failed to submit to EHD notification of designated operator identification or change won 30 days 0 V o R o COS 116 CCR 2715 Designated operator,service tech or installer did not possou current ICC certification o V c R o COS 117 CCR (h) Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ra V c R o COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper test _ OV o R o COS 119 HSC 25299(a)(8), Documents were falsified or misrepresented OV o R o COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V o R o COS 121 CCR 2712(1) Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS 122 CCR 2831Q) Failure to submit and maintain UST system component statement of compatibility for substance stored o V o R o COS i liilllii!i!liii 111 0:01 ii aill 201 CCR 2712(b) Failure to maintain monitoring,maintenance,and follow up action records o V a R o COS FA0004621 PRO232587 SCOW 01 18 EHD 2301 Rev 10/312017 Page 1 of 4 underground Storage Tar*Program OIR 1868 E Hazelton Avenue I Stockton,California 952051 T 209 468-3420 1 F 209 464-0138 1 www,sjcehd.com