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A NJ O A Q U l N Environmental Health Department <br /> COUNTY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Mossdale Chevron 444 W MOSSDALE RD, LATHROP June 28, 2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <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 06/10/2020 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 /> 07/10/2020. 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 /> 208 CCR 2716(a-e) Failure to comply with the designated operator inspection requirements. <br /> OBSERVATION: The designated operator failed to check and note the correct test dates for the last annual <br /> monitoring system certification and leak detector testing on the monthly visual designated operator inspection <br /> reports from July 2020 to June 2021. The incorrect date stated was 6/21/2020 the correct date is 06/10/2020. <br /> REGULATION GUIDANCE: During the inspection, the designated operator shall check that all required testing and <br /> maintenance for the UST system have been completed and document the dates they were done. <br /> CORRECTIVE ACTION: Ensure that designated operators performing inspections at this facility are including all of <br /> the required information on the reports. <br /> This is a repeat violation, Class II. <br /> Overall Inspection Comments: <br /> The monitoring system certification was conducted on 6/28/2021 an inspection checklist was provided to the <br /> facility operator on the day of inspection. The EHD has completed the inspection report on 06/29/2021 which <br /> replaces the initial checklist. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 07/29/2021. <br /> Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate ($152). To schedule an <br /> appointment, please call (209)468-3420. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. <br /> Documents provided: Return to compliance certification form, corrective action statement form and a list of <br /> approve CUPA free training classes. <br /> FA0000212 PR0231692 SCO01 06/28/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 5 of 6 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 />