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Environmental Health Department <br />Underground Storage Tank Program Inspection Report <br />Date: <br />August 14, 2023 <br /> Facility Address: <br /> 13850 N DE VRIES RD, LODI <br /> Facility Name: <br /> Verizon Business: KINGCA <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 /> 117 CCR 2637(e), 2637(f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test. <br />OBSERVATION: Secondary containment testing was performed on 9/20/2022. An incomplete test report was <br />submitted to the EHD on 9/22/2022. An email was sent to the testing company regarding piping certifications on <br />11/4/2022. An updated test report has not been submitted to the EHD. <br />REGULATION GUIDANCE: A copy of the 'Secondary Containment Testing Report Form' must be submitted within <br />30 days of the test. <br />CORRECTIVE ACTION: Immediately provide this report to the EHD. <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 9/13/2023. <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 />($162). 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: Inspector Phone: <br /> SHEWIT WOLDEAREGAY, EH Specialist <br /> Inspector:August 14, 2023 Date: <br />Printed Name and Title: <br />Emailed to Zachary Feingold, Environmental Manager <br />(209) 616-3063 <br />FA0003848 PR0231547 SC001 08/14/2023 <br />EHD 23-01 Rev. 12/06/2021 Underground Storage Tank Program OIRPage 4 of 4 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD