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SQ aQQ N ` ,, � ® Lnvironmental Health Department wr J INITY 1,2,6 11, 1 Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: AM PM HAMMER/15 FOOD #83113 (209) 474-9125 May 26 , 2020 Facility Address : CERS ID: 3250 W HAMMER LN , STOCKTON , CA 95209 10180825 Inspection Contact: Title : Phone: Wesley Parkinson Owner (209) 474-9125 Inspection Type: Program : ROUTINE INSPECTION - Operating Permit 12361 - UST FACILITY Consent For: Consent Given By : 0 Inspection 0 Photos 0 Samples Rommel Santos , Manager Service Technician Onsite : Exp. Date: Designated Operator: Exp. Date: Isaac Anderson 06/ 12/2020 David Turner 06/ 18/2021 Service Technician Manufacturer's Training : VR , 10/22/20 , VMI , 04/08/21 ; OPW, 05/ 11 /22 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 o V ❑ R ❑ COS 2634(d) 105 CCR 2632(d) (2) , Failure to have an approved UST Response Plan o 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 ❑ 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. 1 , Failure to submit and/or maintain documentation regarding compatibility for UST system components ❑ V ❑ R ❑ COS 2665 , 2711 FA0001877 PR0232224 SCO01 05/26/2020 EHD 23-01 Rev. 9/16/2020 Page 1 of 6 Underground Storage Tank Program OIR 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468-34201 F 209 464-0138 1 www . sjgov. org/EHD