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S0 JOA U 1 Environmental Health Department <br /> u ;N i Y I <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Mossdale Chevron 444 W MOSSDALE RD, LATHROP June 10, 2020 <br /> Other Violations <br /> 2010 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 /> 113 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> OBSERVATION:Annual monitoring system certification and leak detector testing was performed on 6/13/2019 and <br /> a test report was submitted on 8/13/2019, one month late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a repeat violation, Class ll. <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 6/13/2019 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 /> 7/12/2019. This information was received on 8/16/2019, one month late. <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 repeat violation, Class ll. <br /> 123 CCR 2637.1(d), 2637.1(e)Failure to submit the"Spill Container Testing Report Form"within 30 days after the test. <br /> OBSERVATION:Annual spill container testing was performed on 6/13/2019 and a test report was submitted on <br /> 8/13/2019,one month late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a repeat violation, Class II. <br /> FA0000212 PR0231692 SCO01 06/10/2020 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 8 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 />