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SAN J O A R N Environmental Health Department <br /> i , �V <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> COSTCO WHOLESALE#658 3250 W GRANT LINE RD,TRACY January 21, 2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 319 CCR 2635, 2637.2,2665, 2712 Failure to comply with overfill prevention equipment requirements. <br /> OBSERVATION: The overfill prevention test results for 9/26/19 state all four tank overfills, including the additive <br /> tank probe,were inspected. The designated operator inspection reports list an overfill prevention test date of <br /> 9/26/19. The alarm history printed on 9/2/20 indicate that the most recent overfill alarm on the additive tank <br /> occurred on 8/27/19. No overfill alarm is listed for the additive tank on 9/26/19. <br /> REGULATION GUIDANCE: Overfill prevention equipment inspections were required to be conducted by October <br /> 13, 2018, and every 36 months thereafter, and within 30 days of completion of a repair. <br /> CORRECTIVE ACTION: Overfill prevention equipment was retested on 9/29/20. Ensure all future inspections and <br /> testing are conducted within the required time frames, and that all test results and inspection reports contain <br /> accurate information. <br /> This is a Class II 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 February 20, 2021. <br /> **The monitoring system certification was conducted on 9/29/20 and was not witnessed by EHD. Immediately <br /> schedule an appointment for a visual inspection and provide 48 hours notification to the EHD. The visual <br /> inspection shall include, but is not limited to: inside all sumps, under dispenser containments, and spill <br /> containers, observation of the monitoring panel for any current alarms, review of a current alarm history printout, <br /> any other items required to determine whether the owner or operator has monitored and tested the tank system <br /> as required by the permit, and whether the tank system is in safe operating condition. Please be aware that all <br /> EHD staff time associated with a follow up inspection will be billed at our current hourly rate ($152). <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: Corrective Action Statement Worksheet, Return to Compliance <br /> Certification form <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: Inspector: Inspector Phone: <br /> Printed Name and Title: STACY RIVERA, Lead Senior REHS 0- <br /> FA0013810 PR0518288 SCO01 01/21/2021 <br /> EHD 23-01 Rev.9/20/2019 Page 5 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.sjcehd.com <br />