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A J OA U I Environmental Health Department <br /> COUNTY <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CHEVRON STATION 4201383 1960 W ELEVENTH ST, TRACY January 13, 2021 <br /> Other Violations <br /> 2010 1 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 /> 118 CCR 2637.2(d&e), 2665(a&b) Failure to submit the "Overfill Prevention Equipment Inspection Report Form"within <br /> 30 days. <br /> OBSERVATION: Overfill prevention testing was performed on 10/05/2018 and a test report was submitted on <br /> 05/15/2019, eleven (11) months late. <br /> REGULATION GUIDANCE: A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a minor violation. <br /> 306 HSC 25291(e) Failure to remove, analyze, and properly dispose of water in secondary containment(pre-Jul 2003). <br /> OBSERVATION: Liquid was observed in the under dispenser containment (UDC) 1/2 sump . <br /> REGULATION GUIDANCE: If water could enter into the secondary containment by precipitation or infiltration, it <br /> must be removed and disposed of properly. <br /> CORRECTIVE ACTION: The service technician removed approximately one cup of liquid from the UDC 1/2. <br /> Ensure that all sumps and annular spaces are maintained free of liquid. <br /> This was corrected on 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 02/12/2021 . <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: Return to complince certification form, corrective action statement form <br /> and a list of approve CUPA schedule free training classes. <br /> FA0004547 PR0232534 SCO01 01/13/2021 <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 />