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Environmental Health Department <br />Underground Storage Tank Program Inspection Report <br />Date: <br />May 25, 2023 <br /> Facility Address: <br /> 3250 W HAMMER LN, STOCKTON <br /> Facility Name: <br /> AM PM HAMMER/I5 FOOD #83113 <br />Single-Walled Non-Pressurized Piping <br /> 404 □ V □ R □ COSFailure to conduct 0.1 gph test on single-walled gravity piping biennially or post repair (pre-1984)CCR 2643(e), 2661(f) <br />Other Violations <br /> 2010 □ V □ R □ COSUnlisted General violation See below <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />RemarksItem # <br /> 107 HSC 25292.2; CCR 2711(a)(11) Failure to submit and maintain complete and current financial responsibility <br />documents. <br />1) OBSERVATION: Financial responsibility documents have not been submitted to the EHD. The certification of <br />financial responsibility does not list all mechanism types being used. Per the facility application, “state fund and CFO <br />letter” was selected. For owners or operators of petroleum underground storage tanks that are located at petroleum <br />marketing facilities, or that handle an average of more than 10,000 gallons of petroleum per month based on annual <br />throughput for the previous calendar year; $1 million per occurrence is required. The per occurrence and annual <br />aggregate coverage amounts listed on the CFO letter should be the amount covered by the letter. <br />REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br />CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS) at <br />http://cers.calepa.ca.gov/, and upload the required documents. <br />----------------------------------------------------------- <br />2) 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 II. <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OBSERVATION: The designated operator identification form is outdated. <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 repeat violation, Class II. <br />FA0001877 PR0232224 SC001 05/25/2023 <br />EHD 23-01 Rev. 12/06/2021 Underground Storage Tank Program OIRPage 4 of 9 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD