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S A N-J OQQ U S N Environmental Health Department l .. COUNTY Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: MY MINI MART 209 941-2246 June 06 2019 Facility Address: CERS ID: 1756 N WILSON WAY STOCKTON CA 95205 10180819 Inspection Contact: Title: Phone: Ashish Boveja Owner 209 941-2246 Inspection Type: Program: ROUTINE INSPECTION -Operatinq Permit 12361 - UST FACILITY Consent For: IConsent Given By: Z Inspection 0 Photos N Samples I All ssa Delsied Manager Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: David Winkler 03/31/2020 Zane Nimmo 02/25/2020 Service Technician Manufacturer's Training TT 03/31/20; Incon 11/30/20; OPW,03/14/20; VMI, 11/10/19 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 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 o V ❑R o COS 2711(d) 102 HSC 25284(a)(3)(A)/ No written agreement between tank owner and tank operator to monitor the tank system ❑V o R o COS (B) 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents ❑V o R o COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ❑V o R o COS 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan ■V o R o COS 2634(d) 106 CCR 2632(d)(2), Failed to have an approved UST response plan o V o R ❑COS 2634(e) 107 CCR 2632(d),2641(h), Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R ❑COS 2711(a) 108 CCR 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing :71 V o 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 o V o R c COS 110 CCR 2637(e),2637(f) Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test o V o R c COS 111 CCR 2638,26410), Failed to test monitoring and leak detection equipment every 12 months o V o R o COS 2715(f) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V o R ❑COS 113 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test o V c R o COS 114 CCR 2636(f)(3), No 0.1 gph annual line integrity test for pressurized piping,or within 30 days after repair o V c R o COS 2643(c)(3) 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator Identification Form"not submitted within 30 days o V o R e COS 2715(a)(3) 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification o V o R o COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining, recordkeeping,and inspection requirements o V o R o COS 118 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" o V c R ❑COS 2715(a)(2) 119 HSC 25299(a)(8), Documents were falsified or misrepresented o V o R o COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑V o R o COS FA0001858 PR0231300 SCO01 06/06/2019 EHD 23-01 Rev.09/28/2018 Page 1 of 5 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com