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_ e SAN10AQU N Environmental Health Department lei T Y Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: COUNTRY MART GAS & FOOD 209 832-8642 Aril 09 2018 Facility Address: CERS ID: 34243 S CHRISMAN RD TRACY CA 95304 10181085 Inspection Contact: Title: Phone: Taran it Sandhu Owner 209 832-8642 Inspection Type: Program: ROUTINE INSPECTION - Operatinq Permit 12361 - UST FACILITY Consent For: I Consent Given By: 0 Inspection M Photos X Samples I Taran it Sandhu Owner Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Felix Ramirez I Felix Ramirez 02/27/2020 Service Technician Manufacturer's Training VMI 11/07/19 Veeder Root Level 4, 07/06/18 Tank Tester05/05/20 R=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 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)/ No written agreement between tank owner and tank operator to monitor the tank system ❑V ❑R ❑COS (B) 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), Failed to have an approved UST monitoring plan ■V ■R ■COS 2634(d) 106 CCR 2632(d)(2), Failed to have an approved UST response plan ❑V ❑R ❑COS 2634(e) 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 ❑R ❑COS 115 CCR 2715(a) Failed to submit to EHD notification of designated operator identification or change Win 30 days ❑V ❑R ❑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), Documents were falsified or misrepresented ❑V ❑R ❑COS 25299(b)(7) 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 On Site Records FA0003290 PR0231801 SCO01 04/09/2018 EHD 23-01 Rev.10/31/2017 Page 1 of 5 Underground Storage Tank Program OIR