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SAN" J D�l+ �� I 11411" Environmental Health Department <br /> COUNTY— <br /> Underground <br /> �l O U N T Y-- <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Verizon Business: KINGCA 13850 N DE VRIES RD LODI August 21 2019 <br /> Single-Walled Non-Pressurized Piping <br /> 404 CCR 2643(e),2661(f) Biennial 0.1 gph line integrity test for single-walled gravity piping not performed(pre-Jan 1984) ❑V ❑R ❑COS <br /> Other Violations <br /> 2010 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 209 CCR 2716(a-e) Failure to conduct the designated UST operator visual inspection at least once every 30 days. <br /> The following was observed on the designated operator's monthly inspection reports: <br /> -The"NA"in sections VII through XI were not fully explained on the inspection reports. <br /> -Reports were missing date, name and signature of the UST owner/operator. <br /> -On the 10/26/18 the designated operator answered the question regarding UDC sensor locations, however the facility <br /> does not have UDCs. <br /> During the visual inspection,the designated operator shall check all required testing and maintenance for the UST <br /> system have been completed and shall check all required items on the report. Ensure that designed operators <br /> performing visual inspections at this facility are including all of the required information on the reports. <br /> This is a minor violation. <br /> 215 CCR 2712(i) Failure to retain a copy of the permit to operate at the facility. <br /> A copy of the 2019 UST operating permit was not found on site. A copy of the UST operating permit and all <br /> attachments and conditions shall be retained at the facility. Immediately obtain a copy of the permit and retain it on <br /> site. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 9/20/2019 . <br /> Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate ($152). To schedule an <br /> appointment, please call (209)468-3420. <br /> Documents provided: <br /> -Return to compliance certification <br /> -Corrective Action Statement <br /> -EHD class schedule <br /> FA0003848 PR0231547 SCO01 08/21/2019 <br /> EHD 23-01 Rev.09/28/2018 Page 4 of 5 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 />