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RECEIVED FE$ 14W Q l a q�7o 4z� S A NOMMO 212m Environmental Health Department COUNTY k) Tc Lt 5 Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: CHEVRON STATION #212470/2222* (209 ) 834- 1220 February 21 , 2019 Facility Address: CERS ID: 3400 MACARTHUR DR , TRACY , CA 95376 10184563 Inspection Contact Title: Phone : Debbie Rowe UST compliance Coordinato (714 ) 671 -3259 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY Consent For: IConsent Given By: Inspection 0 Photos O Samples Debbie Rowe , UST compliance Coordinator Service Technician Onsite: Exp. Date: Designated Operator: Exp, Date: Jesus Saldivar 06/ 16/2019 Rayana Black 01 / 19/2020 Service Technician Manufacturer's Training: Veeder Root, 05/01 /19; VMI , 11 /20/19, SB , 01 /31 /20 CCR = Title 23 California Code of Regulations HSC = HeEwth and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284 Failed to obtain a permit to operate from the EHD Including but not limited to unpaid permit fees o V ❑ R o COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and lank operator to monitor the tank system o V o R a COS 103 HSC 25292 .2, 25299.30 Failure to submit and maintain complete and current financial responsibility documents o V o R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V ❑ R o COS 105 CCR 2632(d)(1 ), Failed to have an approved UST monitoring plan a V o R o COS 2634(d) 106 CCR 2632(d) (2), Failed to have an approved UST response plan o V ❑ R o COS 2634(e) 107 CCR 2632(d)(1 )(C) Piot plan/site map not submitted or failed to completely show where monitoring Is performed a V o R o COS 108 CCR 2637, 2638(e) , Failed to notify the EHD 48 hours prior to conducting testing ❑ V o R ❑ COS 2643(8) 109 CCR 2637(a-d), 2712 Failed to test secondary containment, or failed to maintain test records for 36 months o V a R o 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 o COS 111 CCR 2638(x) 8 (b) , Failed to test monitoring and leak detection equipment annually o V o R o COS 26410) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V n R o COS 113 CCR 2638(c) , 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the lest ■ V a R o COS 114 CCR 2636(f) (3), 2643(c) No 0 . 1 gph annual line integrity test for pressurized piping, or within 30 days after repair o V a R a COS (3) 115 CCR 2715(a)( 1 )(B) , " Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days o V o R o 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 ❑ R o COS 118 CCR 2715 (a)(1 ) (A) , Failure to submit the " Underground Storage Tank Statement of Understanding and Compliance Form" o V o R o 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) Felled to submit UST Certification of InstallabonlModificalion o V a R o COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an Inspection report DV ❑ R o COS 122 CCR 2631 , 2640. 1 , Failure to submit and/or maintain documentation regarding compatibility for UST system components o V o R o COS 2665, 2711 FA0014111 PR0518738 SCO01 02/21 /2019 EHD 23-01 Rev 09/28/2018 Page 1 of 6 Underground Storage Tank Program OIR 1868 E Hazelton Avenue Stockton, California 95205 T 209 468-3420 I F 209 464-0138 1 www sjcehd. com