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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 /> ADELFO'S ARCO AM/PM 3443 CHEROKEE RD, STOCKTON December 27, 2022 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 118 CCR 2637.2(d&e), 2665(a&b) Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within <br /> 30 days. <br /> OBSERVATION:An overfill prevention equipment inspection was performed on 12/28/2021 and a test report was <br /> submitted on 2/7/2022, 11 days late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a minor violation. <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 12/28/2021 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 /> 1/27/2021. This information has not been fully 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 /> 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 1/26/2023. <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 /> ($156). To schedule an appointment, please call (209)468-3420. <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: December 27, 2022 Inspector: Inspector Phone: <br /> Printed Name and Title: FREDERICK ERNEST, REHS (209)616-3026 <br /> Emailed report to: Michelle Elik, Manager <br /> FA0024482 PR0542573 SCO01 12/27/2022 <br /> EHD 23-01 Rev.12/06/2021 Page 5 of 5 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 />