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SAN J 0 A Q I I I Irl Environmental Health Department <br /> CCUNT <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CHEVRON STATION#372736/2223 9484 WEST LN, STOCKTON February 03, 2022 <br /> Other Violations <br /> 2010 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 107 HSC 25292.2; CCR 2711(a)(11)Failure to submit and maintain complete and current financial responsibility <br /> documents. <br /> OBSERVATION: Current financial responsibility documents were not found on site. This site is using a Guarantee <br /> to meet the financial responsibility requirement and documentation of a standby trust fund was not found on site. <br /> REGULATION GUIDANCE:A copy of current financial responsibility documents are required to be maintained on <br /> site. <br /> CORRECTIVE ACTION: Immediately obtain a copy of the facility's standby trust fund documents, maintain a copy <br /> on site, and submit a copy to the Environmental Health Department. <br /> This is a repeat violation, Class Il. <br /> Overall Inspection Comments: <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 March 5,2022. <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. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: inspection report, return to compliance certification, corrective action <br /> statement, and list of free CUPA classes. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: February 03, 2022 Inspector: Inspector Phone: <br /> Printed Name and Title: VICKY VANG-LEE, REHS (209)616-3028 <br /> Emailed to Isabel Nunez, Manager <br /> FA0004525 PR0232601 SCO01 02/03/2022 <br /> EHD 23-01 Rev.12/06/2021 Page 4 of 4 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 />