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S A N 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 /> COUNTRY CLUB MOBIL CIRCLE K 2575 COUNTRY CLUB BLVD, STOCKTON January 18, 2023 <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 /> 101 HSC 25284; CCR 2711(d) Failure to obtain a permit to operate from the EHD including but not limited to unpaid <br /> permit fees. <br /> OBSERVATION: Fees for the annual 2023 permit to operate the UST system have not been paid. <br /> REGULATION GUIDANCE: No person may own or operate an UST unless a permit for its operation has been <br /> issued by the local agency to the owner or operator of the UST system. <br /> CORRECTIVE ACTION: Payment was received by the EHD on 1/25/2023.A 2023 UST operating permit has been <br /> issued. <br /> This is a Class I violation. <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. <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 financial responsibility documents and maintain a <br /> copy on site. <br /> This is a repeat violation, Class 11. <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,Amy Winkler, has been conducting inspections and notification was <br /> not provided to the EHD within 30 days of the change. <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 /> FA0006439 PR0231070 SCO01 01/18/2023 <br /> EHD 23-01 Rev.12/06/2021 Page 4 of 10 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 />