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SAN OA N r agill � J4 hvironmental Health Department ,. COU NTY - 2 t ) reotness groo, i here , Underground Storage Tank Program Inspection Report Facility Name: FacilityPhone: Date: QUIK STOP MARKET #551121 (209) 239-2957 May 19 , 2021 Facility Address: ggggCERS ID : 1196 W LOUISE AVE , MANTECA, CA 95336 10180667 Inspection Contact: Title : Phone : MMarty Hilfinger 7Environmental Contact ( 508) 270-4444 Inspection Type: Program : ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY Consent For: Consent Given By: ❑X Inspection ❑X Photos ❑X Samples Kuljit Gill , Manager Service Technician Onsite : Exp. Date: Designated Operator: Exp. Date : Anthony Reyes 09/02/2022 �l Juan Jauregui 10/26/2022 Service Technician Manufacturer's Training : VR , 01 / 14/23 ; VMI , 07/ 10/21 ; SB 3/19/23 / Bravo , 12/ 11 /21 CCR = Title 23 California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284; CCR Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ❑ V ❑ R ❑ COS 2711 (d) 102 CCR 2711 Failure to submit a complete and accurate application for a permit to operate a UST ❑ V ❑ R ❑ COS 103 CCR 2635(f) , 2636(c) (2) Failure to submit the UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 104 CCR 2632(d) (1 ) , Failure to have an approved UST Monitoring Plan ❑ V ❑ R ❑ COS 2634(d) 105 CCR 2632(d) (2) , Failure to have an approved UST Response Plan ❑ V ❑ R ❑ COS 2634(e) 106 CCR 2632(d) , 2641 (h) Failure to submit and maintain a current facility plot plan / site map ❑ V ❑ R ❑ COS 107 HSC 25292.2; CCR Failure to submit and maintain complete and current financial responsibility documents ❑ V ❑ R ❑ COS 2711 (a) (11 ) 108 CCR 2620(b) ; HSC Failure to implement or maintain a written agreement between the UST owner and operator ❑ V ❑ R ❑ COS 25284 (a) (3) 109 CCR 2715(a) (1 ) (B) , Failure to submit "Designated Underground Storage Tank Operator Identification Form" within 30 days ❑ V ❑ R ❑ COS 2715(a) (3) 110 CCR 2715(a) ( 1 ) (A) , Failure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form" ❑ V ❑ R ❑ COS 2715(a) (2) 111 CCR 2637, 2638(e) , Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 2643(g) 112 CCR 2638, 26410) , Failure to have properly qualified service technician test leak detection equipment every 12 months ❑ V ❑ R ❑ COS 2715 (f) 113 CCR 2637(a-d) , 2712(b) Failure to conduct secondary containment testing ❑ V ❑ R ❑ COS ( 1 ) (F) 114 CCR 2636(f) (3) , 2643(c) Failure to perform line integrity test every 12 months or within 30 days of repair of primary pipe Cl V ❑ R ❑ COS (3) 115 CCR 2638(c) , 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test ❑ V ❑ R ❑ COS 116 CCR 2637 . 1 (d), Failure to submit the "Spill Container Testing Report Form" within 30 days ❑ V ❑ R ❑ COS 2637. 1 (e) 117 CCR 2637 (e) , 2637 (f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test ❑ V ❑ R ❑ COS 118 CCR 2637 . 2(d&e) , Failure to submit the "Overfill Prevention Equipment Inspection Report Form" within 30 days ❑ V ❑ R ❑ COS 2665(a&b) 119 CCR 2663 , 2712(b) (6) Failure to comply with tank lining certification , testing, and inspection requirements ❑ V ❑ R ❑ COS 120 CCR 2631 , 2640. 11 Failure to submit and/or maintain documentation regarding compatibility for UST system components ❑ V ❑ R ❑ COS 2665, 2711 FA0000848 PR0231430 SCO01 05/19/2021 EHD 23-01 Rev. 9/16/2020 Page 1 of 6 Underground Storage Tank Program OIR 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www . sjgov. org/EHD