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' 4 f�Fn`I+rr� SAN lOAQUIN Environmental Health Department t . COUNTY Greot.ness grows lie, Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: Verizon Business: LDIKCA (209)367-2688 March 05, 2020 Facility Address: CERS ID: 2500 W Turner Rd, Lodi, CA 95242 10403278 Inspection Contact: Title: Phone: Dennis Gritsko Facility Engineer (916)373-4626 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 12361 - UST FACILITY Consent For: Consent Given By: D Inspection 0 Photos 9 Sample Dennis Grritsko, Facility Engineer Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Ruben Bececerra 02/07/2021 Kraig Kinder 12/07/2020 Service Technician Manufacturer's Training VMI, 08106120; EVO, 02117122; OPW,02/17/22 CCR=Title23 California Code of Regulations HSC=Health and safety Code CFR=Code of FederalRegulations V=Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284;CCR Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees V n R r COS 271 i d 102 HSC 25284(a)(3)(A)1(B) No written agreement between tank owner and tank operator to monitor the tank system V OR ❑COS 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents ■V OR D COS 104 1 CCR 2711 UST operating permit application for facility and tank information not submitted or current V OR ❑COS 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan ■V OR D COS 2634(d) 106 CCR 2632(d)(2). Failed to have an approved UST response plan o V a R c COS 2634(e) 107 CCR 2632(d),2641(h), Plot plan/site map not submitted or failed to completely show where monitoring is performed DV o R c COS 2711 a 108 CCR 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing u V to R o COS 2643(g) 109 CCR 2637(a-d),2712 Failed to test secondary containment,or failed to maintain test records for 36 months PV R COS 110 CCR 2637(e),2637(f) Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test a V OR Q COS 111 CCR 2638,26416), Failed to test monitoring and leak detection equipment every 12 months ci V o R a COS 2715 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V o R LCOS 113 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test D V u R o COS 114 CCR 2636(f)(3),2643(c) No 0.1 gph annual line integrity test for pressurized piping,or within 30 days after repair ca V ❑R u COS (3) 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator Identification Form"not submitted within 30 days a V L)R to COS 2715 a 3 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification V o R COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining,recordkeeping,and inspection requirements V ❑R d COS 118 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" V u R D COS 2715(a)2 119 HSC 25299(a)(8), Documents were falsified or misrepresented p V QR o COS 25299 b 7 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification t V Li R o COS 121 CCR 2712(f) Failure to implement corrections and submit written response within 30 days of receiving the report c V a R a COS FA0003846 PR0232507 SCO01 03;0512020 EHO23.01 Rev,9/20/2019 Page 1 of 5 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com