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a =n )AN4J0AQU1N 1--11(1111:1 COU N T Y -- 9 Environmental Health Department dem©un too 6,06N., C oF e ort _ Facility Name: QUIK STOP MARKET #2121 Facility Phone: (209) 239-2957 Date: May 22, 2018 Facility Address: 1196 W LOUISE AVE, MANTECA, CA 95336 CERS ID: 10180667 Inspection Contact: Sue Kaur Title: Franchise's wife Phone: (209) 239-2957 Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 12361 - UST FACILITY Consent For: 0 Inspection ❑x Photos ❑x Samples Consent Given By: Sue Kaur, Franchise's wife Service Technician Onsite: Exp. Date: Anthony Reyes 10/17/2018 Designated Operator: Exp. Date: Carpenter Curtis 02/05/2019 Service Technician Manufacturers Training: VMI, 07/12/19; Veeder Root, 02/13/19; S Bravo, 01/06/19 CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection ou F�ieview XWEr M Wk 101 HSC 25284 Failure to obtain a valid permit to operate from the EHD including but not limited to unpaid fees ❑ V ❑ R ❑ COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292.2, 25299.30 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 CCR 2632(d)(1), 2634(d) Failed to have an approved UST monitoring plan ❑ V ❑ R ❑ COS 106 CCR 2632(d)(2), 2634(e) Failed to have an approved UST response plan ❑ 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 D R ❑ COS 115 CCR 2715(a) Failed to submit to EHD notification of designated operator identification or change w/in 30 days ❑ V ❑ R o COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 CCR 2663(h) Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑ V ❑ R ❑ COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑ V ❑ R ❑ COS 119 HSC 25299(a)(8), 25299(b)(7) Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ■ V ❑ R ❑ COS 122 CCR 26310) Failure to submit and maintain UST system component statement of compatibility for substance stored ❑ V ❑ R ❑ COS a'�;`+"w M.v #` �� -aa t v?$ "� 'i it-{.,. Y�e+'a+ w,. `,.. i} $. , ,,,..: S , .`vY,,,•ri ACCR (b) Failure to maintain monitoring, maintenance, and follow up action records ❑ V ❑ R ❑ COS FA0000848 PR0231430 SCO01 05/22/2018 EHD 23-01 Rev. 10/31/2017 Page 1 of 5 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue ( Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com