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A N J O A Q U I Environmental Health Department <br /> COUNTY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> COUNTRY CLUB MOBIL CIRCLE K 2575 COUNTRY CLUB BLVD, STOCKTON January 26, 2021 <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 /> 307 HSC 25290.1(c3), 25290.2(c3) Failure to keep water out of the secondary containment system (post-Jul 2003). <br /> OBSERVATION:Water was found in the vent sump. <br /> REGULATION GUIDANCE: Secondary containment shall be constructed to prevent any water intrusion into the <br /> system by precipitation, infiltration, or surface runoff. <br /> CORRECTIVE ACTION: Immediately remove this liquid, make a hazardous waste determination per Title 22 <br /> hazardous waste regulations, and manage accordingly. Immediately contact a properly licensed, trained, and <br /> certified contractor to address the water intrusion into the vent sump under permit and inspection of the EHD, if <br /> needed. <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 2/25/2021 . <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: <br /> Return to Compliance Certification and Corrective Action Statement form, blank UST Response Plan, blank <br /> Financial Responsibility Certification, blank Letter from Chief Financial Officer, blank Statement of <br /> Understanding and Compliance, and blank Owner/Operator Written Agreement <br /> Note: <br /> This site has new owner as of 1/13/2021. Discussed with new owner, Nick Singh: <br /> - UST CERS submittal should be made within 30 days of new ownership to acquire new permit to operate. <br /> - UST Certificate of Financial Responsibility and Letter from Chief Financial Officer should be re-signed and <br /> dated annually and uploaded into CERS. <br /> - Hazardous Waste program and making sure all manifests are kept and sent to DTSC, follow up with <br /> transporter if signed manifest has not been mailed back, hazardous waste label requirements, ensure a Cal <br /> EPA ID number is active for this site under the owner <br /> - Hazardous Materials Business Plan program, CERS submittals should be made annually (starting November <br /> 1st of the previous year until January 15th of the next year), training should be kept on site and should be done <br /> annually. <br /> FA0006439 PR0231070 SCO01 01/26/2021 <br /> EHD 23-01 Rev.9/16/2020 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.sjgov.org/EHD <br />