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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 /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 110 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> OBSERVATION: The Underground Storage Tank Statement of Understanding and Compliance Form was not found <br /> in CERS. <br /> REGULATION GUIDANCE: This form must be uploaded to the California Environmental Reporting System (CERS). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and upload the Underground Storage Tank Statement of Understanding and Compliance <br /> Form for this facility. <br /> This is a Class II violation. <br /> 122 CCR 2712(f)Failure to implement corrections and submit written response within 30 days of receiving the report. <br /> OBSERVATION:An inspection was last done on February 25, 2020 and an inspection report was issued identifying <br /> information to be submitted to bring this site into compliance. This information was required to be submitted by <br /> March 25, 2020. This information has not been received resulting in a non-compliant status for this facility. <br /> REGULATION GUIDANCE:An operator that receives an inspection report shall have 30 days to implement the <br /> corrections specified in the inspection report and comply with permit conditions. The corrective action shall include <br /> all of the recommendations made in the report. The operator shall submit a written response that includes a <br /> statement documenting corrective actions taken or proposing corrective actions which will be taken. <br /> CORRECTIVE ACTION: Ensure that a written response documenting corrective actions taken or proposed is <br /> submitted and all corrections implemented within 30 days of receiving an inspection report. <br /> This is a repeat violation, Class II. <br /> FA0002480 PR0231216 SCO01 02/09/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 5 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 />