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SAN J O A R N Environmental Health Department <br /> -:a U ;� i _# �V AMENDED <br /> 11/4/2021 <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CALIFORNIA TRACY CONNECT INC* 610 S CHEROKEE Ln, LODI October 29, 2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 108 CCR 2620(b); HSC 25284(a)(3)Failure to implement or maintain a written agreement between the UST owner and <br /> operator. <br /> OBSERVATION: The annual operating permit is not issued to the current operator and there is no written <br /> agreement between the person who was issued the permit and the operator to monitor the UST system. <br /> REGULATION GUIDANCE: If a permit is issued to a person other than the operator of the tank, that person shall <br /> enter into a written agreement with the operator of the tank to monitor the UST system. <br /> CORRECTIVE ACTION: Immediately upload the written agreement to the California Environmental Reporting <br /> System (CERS)and submit for review by the EHD. <br /> This is a Class II violation. <br /> 109 CCR 2715(a)(1)(B), 2715(a)(3) Failure to submit"Designated Underground Storage Tank Operator Identification <br /> Form"within 30 days. <br /> OBSERVATION: The Underground Storage Tank Designated Operator Identification Form has not been uploaded <br /> in CERS. <br /> REGULATION GUIDANCE: The owner or operator shall submit a"Designated Underground Storage Tank Operator <br /> Identification Form"no later than 30 days after any change in the designated UST operator(s). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and upload the notification identifying all the designated operators for this facility. <br /> This is a Class II violation. <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 /> FA0014852 PR0521866 SCO01 10/29/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 6 of 9 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 />