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SAN 1 O A Q U I N Environmental Health Department C- CDiJNTY Underground Storage Tank Program Inspection Report Facility Name : Facility Phone: Date : Delta arco ( 209 ) 465-2487 August 20 , 2019 Facility Address: CERS ID: 440 W DR MARTIN LUTHER KING JR BLVD , STOCKTON , CA 95206 10180903 Inspection Contact: Title: Phone: Rajwinder Singh Manager ( 209 ) 594 -2100 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 12361 - UST FACILITY Consent For : Consent Given By : Z Inspection 0 Photos Z Sam les Dilpreet Singh , Assistatnt Manager Service Technician Onsite: Exp. Date : Designated Operator: Exp, Date : Ed Stearns 11 /09/2019 David Winkler 02 /23/2020 Service Technician Manufacturer's Training VMI , 06/ 10/21 ; OPW , 11 /29/ 19 ; VR , 06/02 /20 CCR = Title 23 California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspectio 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 ❑ R ❑ COS 2711 (d) 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 . 21 25299 . 30 Failure to submit and maintain complete and current financial responsibility documents ■ 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(4 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) , 2641 (h) , Plot plan/site map not submitted or failed to completely show where monitoring is performed ■ V o R ❑ COS 2711 a 108 CCR 2637 , 2638(e) , Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 12643(g ) 109 CCR 2637(a-d) , 2712 Failed to test secondary containment, or failed to maintain test records for 36 months ❑ V ❑ R ❑ COS 110 CCR 2637 (e) , 2637(f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test ❑ V ❑ R ❑ COS 111 CCR 2638 , 2641 Q) , Failed to test monitoring and leak detection equipment every 12 months ❑ V ❑ R ❑ COS 2715 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance ❑ V ❑ R ❑ COS 113 CCR 2638(c) , 2638(d ) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test ❑ V ❑ R ❑ 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 ❑ V ❑ R ❑ COS 3 115 CCR 2715 (a) ( 1 )(B) , " Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days ❑ V ❑ R ❑ COS 2715 a 3 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 CCR 2663 , 2712 (b) (6) Failure to comply with tank lining , recordkeeping , and inspection requirements ❑ V ❑ R ❑ COS 118 CCR 2715(a)( 1 ) (A) , Failure to submit the " Underground Storage Tank Statement of Understanding and Compliance Form" ❑ V ❑ R ❑ COS 2715 a 2 119 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 o COS 122 CCR 2631 , 2640 . 1 , Failure to submit and/or maintain documentation regarding compatibility for UST system components ❑ V ❑ R ❑ COS 2665 , 2711 FA0002321 PR0231055 SC001 08/20/2019 EHD 23-01 Rev. 09/28/2018 Page 1 of 6 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