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Environmental Health Department AMENDED 6/23/2020 Facility Name: ARCO AM/PM #83831* Facility Address: 1904 DANIELS ST, MANTECA, CA 95337 Facility Phone: (209) 579-4014 Program: 2351 - UST FACILITY - 2481 COMPLIANT Inspection Type: ROUTINE INSPECTION - Operating Permit Date: April 07, 2020 CERS ID: 10761034 Inspection Contact: Ranjeet Sign Consent For: Consent Given By: Tracie Jones, Manager Title: Owner Phone: (209) 579-4014 T Inspection T Photos £ Samples Underground Storage Tank Program Inspection Report Service Technician Manufacturer's Training: VMI, 06/12/21; OPW, 06/07/21; VR, 10/05/21 Service Technician Onsite: Guadalupe Sanchez Exp. Date: 01/21/2021 Designated Operator: Guadalupe Sanchez Exp. Date: 01/21/2021 HSC = Health and Safety Code CFR = Code of Federal RegulationsCCR = Title 23 California Code of Regulations R = Repeat violation COS = Corrected on site during inspectionV = Violation File Review 101 □ V □ R □ COSFailed to obtain a permit to operate from the EHD including but not limited to unpaid permit feesHSC 25284; CCR 2711(d) 102 □ V □ R □ COSNo written agreement between tank owner and tank operator to monitor the tank systemHSC 25284(a)(3)(A)/(B) 103 ■ V □ R □ COSFailure to submit and maintain complete and current financial responsibility documentsHSC 25292.2, 25299.30 104 □ V □ R □ COSUST operating permit application for facility and tank information not submitted or currentCCR 2711 105 □ V □ R □ COSFailed to have an approved UST monitoring planCCR 2632(d)(1), 2634(d) 106 □ V □ R □ COSFailed to have an approved UST response planCCR 2632(d)(2), 2634(e) 107 □ V □ R □ COSPlot plan/site map not submitted or failed to completely show where monitoring is performedCCR 2632(d), 2641(h), 2711(a) 108 □ V □ R □ COSFailed to notify the EHD 48 hours prior to conducting testingCCR 2637, 2638(e), 2643(g) 109 □ V □ R □ COSFailed to test secondary containment, or failed to maintain test records for 36 monthsCCR 2637(a-d), 2712 110 □ V □ R □ COSFailed to submit "Secondary Containment Testing Report Form" within 30 days after the testCCR 2637(e), 2637(f) 111 □ V □ R □ COSFailed to test monitoring and leak detection equipment every 12 monthsCCR 2638, 2641(j), 2715(f) 112 □ V □ R □ COSFailure to maintain UST records to enable the UPA to determine whether the UST is in complianceHSC 25293 113 □ V □ R □ COSFailure to submit "Monitoring System Certification Form" within 30 days of completion of the testCCR 2638(c), 2638(d) 114 □ V □ R □ COSNo 0.1 gph annual line integrity test for pressurized piping, or within 30 days after repairCCR 2636(f)(3), 2643(c) (3) 115 □ V □ R □ COS"Designated Underground Storage Tank Operator Identification Form" not submitted within 30 daysCCR 2715(a)(1)(B), 2715(a)(3) 116 □ V □ R □ COSDesignated operator, service tech or installer did not possess current ICC certificationCCR 2715 117 □ V □ R □ COSFailure to comply with tank lining, recordkeeping, and inspection requirementsCCR 2663, 2712(b)(6) 118 □ V □ R □ COSFailure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form"CCR 2715(a)(1)(A), 2715(a)(2) 119 □ V □ R □ COSDocuments were falsified or misrepresentedHSC 25299(a)(8), 25299(b)(7) 120 □ V □ R □ COSFailed to submit UST Certification of Installation/ModificationCCR 2635(d) 121 □ V □ R □ COSFailure to implement corrections and submit written response within 30 days of receiving the reportCCR 2712(f) FA0024059 PR0541937 SC001 04/07/2020 EHD 23-01 Rev. 9/20/2019 Underground Storage Tank Program OIRPage 1 of 5 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com