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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUN r <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> SHOP N GO 3 14511 PACIFIC AVE, STOCKTON February 09, 2021 <br /> Single-Walled Non-Pressurized Piping <br /> 404 CCR 2643(e),2661(f) Failure to conduct 0.1 gph test on single-walled gravity piping biennially or post repair(pre-1984) ❑V ❑R ❑COS <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 /> 104 CCR 2632(d)(1), 2634(d)Failure to have an approved UST Monitoring Plan. <br /> OBSERVATION: The monitoring plan is not current and/or not approved by the EHD. The monitoring panel is listed <br /> as a TLS 350. A TLS 350 Plus was observed on site. <br /> REGULATION GUIDANCE: The monitoring plan must be uploaded to the California Environmental Reporting <br /> System (CERS). <br /> CORRECTIVE ACTION: Immediately log into CERS, make the necessary changes, and submit for review by the <br /> EHD. <br /> This is a minor violation. <br /> 107 HSC 25292.2; CCR 2711(a)(11)Failure to submit and maintain complete and current financial responsibility <br /> documents. <br /> OBSERVATION: Financial responsibility documents have not been submitted to the EHD. The most recent <br /> financial responsibility documents in CERS are dated May 13, 2018. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/, and upload the required documents. <br /> This is a repeat violation, Class ll. <br /> 109 CCR 2715(a)(1)(B), 2715(a)(3) Failure to submit"Designated Underground Storage Tank Operator Identification <br /> Form"within 30 days. <br /> OBSERVATION:A new designated operator, Renee Arnaiz, began conducting inspections on 10/15/2020 and <br /> notification was not provided to the EHD within 30 days of the change. <br /> REGULATION GUIDANCE: The owner or operator shall submit a"Designated Underground Storage Tank Operator <br /> Identification Form"no later than 30 days after any change in the designated UST operator(s). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and upload the notification identifying all the designated operators for this facility. <br /> This is a minor violation. <br /> FA0002480 PR0231216 SCO01 02/09/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 4 of 7 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 />