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S A N J O A Q U I N Environmental Health Department <br /> C.0 LJ N I Y <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> DSS COMPANY 655 W CLAY ST, STOCKTON July 20, 2022 <br /> Single-Walled Non-Pressurized Piping <br /> 404 CCR 2643(e),2661(f) Failure to conduct 0.1 gph test on single-walled gravity piping biennially or post repair(pre-1984) ❑V ❑R ❑COS <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 /> 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:A new designated operator, Patrick Oneill Casey, began conducting inspections on 4/25/2022 and <br /> notification was not provided to the EHD within 30 days of the change.A CERS submittal with the updated DO form <br /> was submitted on 6/17/2022. <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: Provide a corrective action statement to the EHD. <br /> This is a minor violation. <br /> FA0003699 PR0231065 SCO01 07/20/2022 <br /> EHD 23-01 Rev.9/16/2020 Page 4 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 />