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S A J O A Q U I N Environmental Health Department <br /> C 0 u T - AMENDED <br /> 9/30/2020 <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Lawrence Livermore National Lab-Site 300 15999 W CORRAL HOLLOW RD, TRACY JUly 29, 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 /> 115 CCR 2715(a)(1)(B), 2715(a)(3)"Designated Underground Storage Tank Operator Identification Form"not submitted <br /> within 30 days. <br /> OBSERVATION: The designated operator identification information submitted on 7/20/2020 is on an outdated form. <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 notification identifying all the designated operators for this facility. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> An inspection report was provided to the facility operator on the day of inspection. The report was amended <br /> and replaces the initial report. Violation 209 has been removed. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, within 30 days of receiving the amended inspection report. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: September 30, 2020 Inspector: Inspector Phone: <br /> Printed Name and Title: SHEWIT WOLDEAREGAY, EH Specialist (209)616-3063 <br /> Emailed <br /> FA0003934 PR0231945 SCO01 07/29/2020 <br /> EHD 23-01 Rev.9/16/2020 Page 4 of 4 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 />