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SAN J O A R N Environmental Health Department <br /> -:a U ;� i _# �V AMENDED <br /> 11/6/2019 <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Super Store Industries-Grocery Division 16888 McKinley Ave, Lathrop October 25, 2019 <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 8/22/2019 report was signed on 8/26/2019, passed the 48-hours mark. <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 /> Overall Inspection Comments: <br /> An inspection report was provided to the facility operator on the day of inspection. The report was amended by <br /> the EHD. Violation 201 has been removed, this amended report replaces the initial report. Complete and submit <br /> a copy of the Return to Compliance Certification form to the EHD with a statement documenting the corrective <br /> actions that have been or will be taken for each violation, and any supporting paperwork, within 30 days of <br /> receiving the amended inspection report. <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 during inspection: <br /> -Return to compliance certification <br /> -Corrective Action Statement <br /> -EHD class schedule <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: November 06, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: SHEWIT WOLDEAREGAY, EH Specialist (209)468-0216 <br /> Emailed <br /> FA0003833 PR0232523 SCO01 10/25/2019 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 4 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 />