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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUN r <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> H&M- BW#98 2501 JACKSON AVE, ESCALON July 19, 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 /> 104 CCR 2632(d)(1), 2634(d)Failure to submit a complete and accurate UST Monitoring Plan. <br /> OBSERVATION: The monitoring plan is not current and/or not approved by the EHD. The 91 leak detector on <br /> CERS is listed as a VMI. On site a Red Jacket leak detector was observed in the 91 STP sump. <br /> REGULATION GUIDANCE: The monitoring plan must be uploaded to the California Environmental Reporting <br /> System (CERS). <br /> CORRECTIVE ACTION: Immediately log into CERS, make the necessary changes, and submit for review by the <br /> EHD. <br /> This is a repeat violation, Class II. <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 3/25/2023&3/28/2023.A test <br /> report has not been submitted to the EHD or the California Environmental Reporting System (CERS). <br /> REGULATION GUIDANCE:A copy of the inspection report form must be submitted within 30 days of the test. <br /> CORRECTIVE ACTION: Immediately provide this report to the EHD. <br /> This is a repeat violation, Class II. <br /> 120 CCR 2631, 2640.1,2665, 2711 Failure to submit and/or maintain documentation regarding compatibility for UST <br /> system components. <br /> OBSERVATION:A statement of compatibility for the 91 premium has not been submitted for the Red Jacket FXIV. <br /> REGULATION GUIDANCE: Since the independent testing organization for the Red Jacket FXIV did not include a <br /> statement of compatibility for the 91 premium product to be used with the Red Jacket FXIV, a written, affirmative <br /> statement of compatibility for the 91 premium product from the manufacturer shall be submitted. <br /> CORRECTIVE ACTION: Immediately submit an affirmative statement of compatibility or replace the 91 premium <br /> product with a component that meets all applicable Title 23 requirements for a UST system. <br /> This is a minor violation. <br /> FA0003910 PR0231488 SCO01 07/19/2023 <br /> EHD 23-01 Rev.12/06/2021 Page 4 of 7 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 />