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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 /> Delta arco 1 440 W DR MARTIN LUTHER KING JR BLVD, August 02, 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:A permit to operate the UST system has not been issued. <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: Immediately obtain a permit to operate a UST system from the EHD. <br /> This is a Class I violation. <br /> 102 CCR 2711 Failure to submit a complete and accurate application for a permit to operate a UST. <br /> OBSERVATION: The UST Facility Operating Permit Application contains an incorrect California Department of Tax <br /> and Fee Administration (CDTFA) Underground Storage Tank Account Number. <br /> REGULATION GUIDANCE: The application for a permit to operate an underground storage tank shall include the <br /> CDTFA registration number issued to the owner of the tank, in accordance with HSC 25286. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS), update the <br /> required information, and submit for review by the EHD. <br /> This is a minor violation. <br /> 107 HSC 25292.2; CCR 2711(a)(11)Failure to submit and maintain complete and current financial responsibility <br /> documents. <br /> OBSERVATION: The certification of financial responsibility form is missing a witness signature. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION:An updated certification of financial responsibility form was uploaded into CERS and the <br /> time of the inspeciton. <br /> This is a minor violation. <br /> FA0002321 PR0231055 SCO01 08/02/2023 <br /> EHD 23-01 Rev.12/06/2021 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 />