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A NJ O A Q U l N Environmental Health Department <br /> COUNTY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> KWIK SERV LODI BW 113* 420 W KETTLEMAN LN, LODI January 11, 2024 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 106 CCR 2632(d), 2641(h) Failure to submit and maintain a current facility plot plan/site map. <br /> OBSERVATION:An accurate UST Monitoring Site Plan was not submitted. <br /> -There were no sensors indicated in the tank sumps on the site map. The site map is labeled with letters that are <br /> not in the key/legend. <br /> REGULATION GUIDANCE:A site plan must be submitted identifying the locations where monitoring will be <br /> performed. The site plan must show the general layout of tanks and clearly identify locations of the following <br /> equipment, if installed: 1)monitoring panels; 2)in-tank liquid level probes(if used for leak detection); 3)devices <br /> monitoring tank annular spaces or vault; 4)devices monitoring product piping; 5)devices monitoring fill piping; 6) <br /> devices monitoring vent piping; 7)devices monitoring vapor recovery piping; 8)devices monitoring vent/transition <br /> sumps; 9)devices monitoring under-dispenser containment; 10)line leak detectors; and 11)devices monitoring any <br /> other secondary containment areas. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/and upload a copy of the UST Monitoring Site Plan. <br /> This is a repeat violation, Class II. <br /> 110 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> OBSERVATION: The Underground Storage Tank Statement of Understanding and Compliance Form was <br /> incomplete.The site address, city and ZIP code were left blank. <br /> REGULATION GUIDANCE: This form must be uploaded to the California Environmental Reporting System (CERS). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and update the Underground Storage Tank Statement of Understanding and Compliance <br /> Form for this facility. <br /> This is a Class II violation. <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 E85 fuel has not been submitted for the VR-343 annular sensor. <br /> REGULATION GUIDANCE: Since the independent testing organization for the Veeder Root-343 annular sensor did <br /> not include a statement of compatibility for E85 fuel to be used with the Veeder Root-343 annular sensor, a written, <br /> affirmative statement of compatibility for the E85 fuel from the manufacturer shall be submitted. <br /> CORRECTIVE ACTION: Immediately submit an affirmative statement of compatibility or replace the VR-343 with a <br /> component that meets all applicable Title 23 requirements for a UST system. <br /> This is a minor violation. <br /> FA0003776 PR0231906 SCO01 01/11/2024 <br /> EHD 23-01 Rev.12/06/2021 Page 5 of 9 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 />