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SAN J O A Q U I N Environmental Health Department Underground Storage Tank Program Inspection Report Facility Name : Facility Phone : Date : UNITED # 5447 ( 310 ) 323-3992 August 06 , 2019 Facility Address : CERS ID : 1469 E HAMMER LN , STOCKTON , CA 95210 10180781 Inspection Contact: Title: Phone: Janene Asuncion Manager ( 209 ) 47 & 1522 Inspection Type: Program : ROUTINE INSPECTION - CieratinPermit 2361 - UST FACILITY Consent For: Q I Consent Given By : 0 Inspection Z Photos 0 Sam les I Janene Asuncion , M er Service Technician Onsite: Exp, Date : Designated Operator: Exp, Date : Garrett Warren 10/02/2019 Eva Barroso Traylor 02/25/2021 Service Technician Manufacturer's Training VMI , 05/01 /20 ; VR , 01 /21 /21 ; OPW( SB ) , 06/05/21 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 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 L 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 n V c R COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current 7V R COS 105 2 C34( 2d632 (d)( 1 ) , Failed to have an approved UST monitoring plan V = R COS 106 CCR 2632 (d ) (2) , Failed to have an approved UST response plan V ❑ R 7 COS 2634(e) 107 CCR 2632 (d ) , 2641 (h ) , Plot plan/site map not submitted or failed to completely show where monitoring is performed V R COS 2711 ( a ) G L,. A 108 CCR 2637 , 2638 (e ) , Failed to notify the EHD 48 hours prior to conducting testing - V R COS 2643(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 , 26410 ) , Failed to test monitoring and leak detection equipment every 12 months V R COS 2715(f) 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) 0 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 G GS V R COS FA0001570 PR0231126 SCO01 08/06/2019 EHD 23-01 Rev, 09/28/2018 Page 1 of 5 Underground Storage Tank Program OIR 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468- 3420 F 209 464 -0138 1 www . sjcehd . corn