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S A N rJ O A Q U I N Environmental Health Department OUNTY Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: SAFEWAY FUEL CENTER#2600 (925)467-3000 June 18, 2019 Facility Address: CERS ID: 1987 W ELEVENTH ST, TRACY, CA 95376 10156819 Inspection Contact: Title: Phone: Aldo Basurto Environmental Contact 925 580-8131 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 2361 -UST FACILITY Consent For: Consent Given By: ❑O Inspection ❑O Photos ❑O Samples Will Raufman, Mana er Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Steve Parmenter 02/24/2021 Rita Martinez 01/25/2019 Service Technician Manufacturer's Training: Veeder Root, 04/04/21; VMI, 03/29/21; SB, 05/22/20 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 File Review 101 HSC 25284 Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ❑V o R o COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system ❑V ❑R ❑COS 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents ❑V o R ❑COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ■V ■R ❑COS 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan ❑V ❑R ❑COS 12634(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) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R o COS 108 CCR 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing ❑V ❑R ❑COS 2643(g) 109 CCR 2637(a-d),2712 Failed to test secondary containment,or failed to maintain test records for 36 months c V ❑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 ❑COS 111 CCR 2638(a)&(b), Failed to test monitoring and leak detection equipment annually ❑V D R ❑COS 26410) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance ❑V ❑R ❑COS 113 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test ❑V ❑R ❑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 ❑V ❑R ❑COS (3) 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator Identification Form"not submitted within 30 days ❑V ❑R ❑COS 2715(a)(3) 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R o COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining,recordkeeping,and inspection requirements ❑V ❑R ❑COS 118 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" o V ❑R ❑COS 2715(a)(2) 119 HSC 25299(a)(8), Documents were falsified or misrepresented o V ❑R ❑COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V o R o COS ]121CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS CCR 2631,2640.1, Failure to submit and/or maintain documentation regarding compatibility for UST system components o V ❑R ❑COS 2665,2711 FA0013503 PRO517565 SCO01 06/18/2019 EHD 23-01 Rev.09/28/2018 Page 1 of 6 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com