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A91k Ah Page 1 of 5 San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s6aov.org/ehd JAN 2 7 2016 Underground Storage Tank Program Inspection ReportHEALTH DEPARTMEN Facility Name: Pacific Avenue Chevron Facility Phone: (209) 477-4294 Date: January 19 2016 Facility Address: 6633 PACIFIC AVE, Stockton, CA 95207 CERS ID: 10594654 Inspection Contact; Ruvian Laurel Title: Manager Phone: (209) 477-4294 Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 2361 - LIST FACILITY Consent For: X Inspection Cl Photos X< Samples Consent Given By: Cassandra Rogers, Assistant Manager Service Technician Onsite Zane Nimmo Exp. Date: 06/19/2017 Designated Operator: Michael Reimers Exp. Date: 09/0212016 Service Technician Manufacturer's Training VMI. 02/02/17, VR, 09/27/17. Tank Tester,l 1/10/16 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 File Review 101 HSC 25284 No permit to operate V R 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 nV R COS 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current =4, V R COS 105 HSC 25286(c) Current BOE number not submitted �1V R COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD :iV R -J COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed V r:R ,,, COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing V R :iCOS 109 CCR 2637 Failed to test secondary containment iV i R 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days iV : R c COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually i i 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 1000' 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 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after i., R COS �COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ;iV R :, COS 122 HSC 25299 Documents were falsified or misrepresented R t: COS 123 CCR 2661 Permit to repair UST system not obtained V R , J COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification V R f; COS 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report V R COS eiv by (Initial) [ nspector: I� FATINAH ZAREEF, RENS —7209) hone: 953-7311 Date: 01/19/2016 Page 1 of 5