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Environmental Health Department Facility Name: SRH FOOD & GAS Facility Address: 749 E DR MARTIN LUTHER KING JR BLVD, STOCKTON, CA 95206 Facility Phone: (209) 465-8979 Program: 2361 - UST FACILITY Inspection Type: ROUTINE INSPECTION - Operating Permit Date: May 28, 2021 CERS ID: 10181497 Inspection Contact: Muhammad Rizwan Consent For: Consent Given By: Muhammad Rizwan, Owner Title: Owner Phone: (209) 271-2578 T Inspection T Photos £ Samples Underground Storage Tank Program Inspection Report Service Technician Manufacturer's Training: VMI, 06/18/21; OPW, 03/12/22; Veeder-Root, 02/27/22 Service Technician Onsite: Edward Stearns Exp. Date: 11/06/2022 Designated Operator: Edward Stearns Exp. Date: 02/27/2022 HSC = Health and Safety Code CFR = Code of Federal RegulationsCCR = Title 23 California Code of Regulations R = Repeat violation COS = Corrected on site during inspectionV = Violation File Review 101 □ V □ R □ COSFailure to obtain a permit to operate from the EHD including but not limited to unpaid permit feesHSC 25284; CCR 2711(d) 102 □ V □ R □ COSFailure to submit a complete and accurate application for a permit to operate a USTCCR 2711 103 □ V □ R □ COSFailure to submit the UST Certification of Installation/ModificationCCR 2635(f), 2636(c)(2) 104 □ V □ R □ COSFailure to have an approved UST Monitoring PlanCCR 2632(d)(1), 2634(d) 105 □ V □ R □ COSFailure to have an approved UST Response PlanCCR 2632(d)(2), 2634(e) 106 □ V □ R □ COSFailure to submit and maintain a current facility plot plan / site mapCCR 2632(d), 2641(h) 107 □ V □ R □ COSFailure to submit and maintain complete and current financial responsibility documentsHSC 25292.2; CCR 2711(a)(11) 108 □ V □ R □ COSFailure to implement or maintain a written agreement between the UST owner and operatorCCR 2620(b); HSC 25284(a)(3) 109 □ V □ R □ COSFailure to submit "Designated Underground Storage Tank Operator Identification Form" within 30 daysCCR 2715(a)(1)(B), 2715(a)(3) 110 □ V □ R □ COSFailure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form"CCR 2715(a)(1)(A), 2715(a)(2) 111 □ V □ R □ COSFailed to notify the EHD 48 hours prior to conducting testingCCR 2637, 2638(e), 2643(g) 112 □ V □ R □ COSFailure to have properly qualified service technician test leak detection equipment every 12 monthsCCR 2638, 2641(j), 2715(f) 113 □ V □ R □ COSFailure to conduct secondary containment testingCCR 2637(a-d), 2712(b) (1)(F) 114 □ V □ R □ COSFailure to perform line integrity test every 12 months or within 30 days of repair of primary pipeCCR 2636(f)(3), 2643(c) (3) 115 □ V □ R □ COSFailure to submit "Monitoring System Certification Form" within 30 days of completion of the testCCR 2638(c), 2638(d) 116 □ V □ R □ COSFailure to submit the "Spill Container Testing Report Form" within 30 daysCCR 2637.1(d), 2637.1(e) 117 □ V □ R □ COSFailed to submit "Secondary Containment Testing Report Form" within 30 days after the testCCR 2637(e), 2637(f) 118 □ V □ R □ COSFailure to submit the "Overfill Prevention Equipment Inspection Report Form" within 30 daysCCR 2637.2(d&e), 2665(a&b) 119 □ V □ R □ COSFailure to comply with tank lining certification, testing, and inspection requirementsCCR 2663, 2712(b)(6) 120 □ V □ R □ COSFailure to submit and/or maintain documentation regarding compatibility for UST system componentsCCR 2631, 2640.1, 2665, 2711 FA0003870 PR0231060 SC001 05/28/2021 EHD 23-01 Rev. 9/16/2020 Underground Storage Tank Program OIRPage 1 of 6 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD