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SAN" J D�l+ �� I 1411" Environmental Health Department <br /> COUNTY— <br /> Underground <br /> �l O U N T Y— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: F2W <br /> ility Address: Date: <br /> SHORT STOP FOOD MART TURNER RD LODI Se tember 03 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 107 CCR 2632(d), 2641(h), 2711(a) Plot plan/site map not submitted or failed to completely show where monitoring is <br /> performed. <br /> An accurate UST Monitoring Site Plan was not submitted.The monitoring site plan (map)does not include piping. A <br /> site plan must be submitted identifying the locations where monitoring will be performed. Immediately log into the <br /> California Environmental Reporting System (CERS)at http://cers.calepa.ca.gov/and upload a copy of the UST <br /> Monitoring Site Plan. <br /> This was corrected on site. <br /> This is a minor violation. <br /> 115 CCR 2715(a)(1)(B), 2715(a)(3)"Designated Underground Storage Tank Operator Identification Form"not submitted <br /> within 30 days. <br /> The Statement of Designated Operator has not been updated to include accurate information.Alex Jabbari is <br /> performing designated operator inspections at the facility and is not listed on the submitted statement of designated <br /> operators. Notification was not provided to the EHD within 30 days of the change. Immediately log into the California <br /> Environmental Reporting System (CERS)at http://cers.calepa.ca.gov and upload the notification identifying all the <br /> designated operators for this facility. <br /> This was corrected on site. <br /> This is a minor violation. <br /> 118 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> The Underground Storage Tank Statement of Understanding and Compliance Form was not found in CERS. This form <br /> must be uploaded to the California Environmental Reporting System (CERS). Immediately log into the California <br /> Environmental Reporting System (CERS)at http://cers.calepa.ca.gov and upload the Underground Storage Tank <br /> Statement of Understanding and Compliance Form for this facility. <br /> This was corrected on site. <br /> This is a minor violation. <br /> 124 CCR 2637.2(d&e), 2665(a&b)"Overfill Prevention Equipment Inspection Report Form" not submitted within 30 days of <br /> inspection. <br /> Overfill Prevention Equipment testing was performed on 3/5/2019 and a test report was submitted on 9/3/2019,4 <br /> months late. A copy of the test report must be submitted within 30 days of the tests. Take all necessary precautions <br /> to ensure testing and submittal of test reports are performed in a timely manner. <br /> This is a minor violation. <br /> FA0000645 PR0231380 SCO01 09/03/2019 <br /> EHD 23-01 Rev.08/27/2019 Page 5 of 7 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />