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r . SAN JOANN <br />C O l._ N T - <br />�,F, G(eoo)ess grows stere. <br />Environmental Health Department <br />AMENDED <br />1/16/2025 <br />CP22 - UST FULL Inspection Report <br />Facility Name: <br />Facility Phone: <br />Date: <br />CHEVRON USA#201761* <br />209 825-0714 <br />January 14 2025 <br />Facility Address: <br />CERS ID: <br />1103 S MAIN ST MANTECA CA 95337 <br />10181653 <br />Inspection Contact: <br />Title: <br />Phone: <br />Inspection Type: <br />Program: <br />12361 <br />Routine <br />- UST FACILITY <br />Consent For: <br />Consent Given By: <br />❑x Inspection ❑x Photos ❑x Samples <br />Veronica Corona Manager <br />Service Technician Onsite: Exp. Date: <br />Designated Operator: Exp. Date: <br />Jesus Saldivar 05/16/2025 <br />Trent Heinrich 8/29/2025 <br />Service Technician Manufacturer's Training: <br />VR, 04/04/2025; OPW, 01/07/2027; VMI, 11/07/2025 <br />OUT = Violation R = Repeat violation COS = Corrected on site during inspection <br />1 <br />CA Health and Safety <br />2030021 - Facility has a valid Permit to Operate from the CUPA <br />❑ OUT ❑ R ❑ COS <br />Code 25284; CCR <br />2711(d) <br />2 <br />CA Code of Regulations <br />2010010 - Complete and accurate UST Operating Permit Application has been submitted. <br />❑ OUT ❑ R ❑ COS <br />2711 <br />3 <br />CA Code of Regulations <br />2010013 - Facility has submitted a complete and accurate UST Monitoring Plan. <br />❑ OUT ❑ R ❑ COS <br />2632(d)(1), 2634(d) <br />4 <br />CA Code of Regulations <br />2010014 - Facility has submitted a complete and accurate UST Response Plan. <br />❑ OUT ❑ R ❑ COS <br />2632(d)(2), 2634(e) <br />5 <br />CA Code of Regulations <br />2030041 - A current facility plot plan is maintained and has been submitted <br />❑ OUT ❑ R ❑ COS <br />2632(d), 2641(h) <br />6 <br />CA Health and Safety <br />2010006 - Owner/Operator has not made false statements, certifications, or representations on <br />❑ OUT ❑ R ❑ COS <br />Code 25299(a)(8), <br />documents <br />25299(b)(7) <br />7 <br />CA Code of Regulations <br />2010003 - Owner/Operator submitted DO form and/or informed the CUPA of any change(s) within <br />❑ OUT ❑ R ❑ COS <br />2715(a)(1)(B), 2715(a) <br />30 days (TCR 10) <br />(3) <br />8 <br />CA Code of Regulations <br />2010016 - "Underground Storage Tank Statement of Understanding and Compliance Form" <br />❑ OUT ❑ R ❑ COS <br />2715(a)(1)(A), 2715(a) <br />submitted (TCR 10) <br />(2) <br />9 <br />CA Code of Regulations <br />2030002 - Leak detection equipment tested by qualified service technician every 12 months (TCR <br />❑ OUT ❑ R ❑ COS <br />2638, 26410), 2715(f) <br />9d) <br />10 <br />CA Code of Regulations <br />2030074 - Annual Monitoring System Certification Form to the CUPA within 30 days of completion of <br />❑ OUT ❑ R ❑ COS <br />2638(c), 2638(d) <br />the test <br />11 <br />CA Code of Regulations <br />2030048 - Sec containment testing conducted per requirements & records kept for 36 mths (TCR <br />❑ OUT ❑ R ❑ COS <br />2637(a -d), 2712(b)(1) <br />9d) <br />(F) <br />12 <br />CA Code of Regulations <br />2010009 - Secondary containment test results submitted to the CUPA within 30 days after the test. <br />❑ OUT ❑ R ❑ COS <br />2637(e), 2637(f) <br />13 <br />CA Code of Regulations <br />2010017 - Spill bucket testing results submitted to the UPA within 30 days of testing <br />❑ OUT ❑ R ❑ COS <br />2637.1(d), 2637.1(e) <br />14 <br />CA Code of Regulations <br />2010018 - Overfill prevention equipment inspection report form submitted to the UPA within 30 days <br />❑ OUT ❑ R ❑ COS <br />2637.2(d&e), <br />2665(a&b) <br />15 <br />CA Code of Regulations <br />2030042 - Line integrity test completed on DW press piping every 12 mths if no fail safe / + <br />❑ OUT ❑ R ❑ COS <br />2636(f)(3), 2643(c)(3) <br />shutdown (TCR 9d) <br />16 <br />CA Code of Regulations <br />2030050 - 0.1 gph piping test conducted on SW suction systems every 36 mths and after piping <br />❑ OUT ❑ R ❑ COS <br />2643(d), 2661(f) <br />repair (TCR 9d) <br />FA0004521 PR0232587 SCO01 01/14/2025 <br />EHD Rev. 12/06/2021 Page 1 of 6 CP22 - UST FULL 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 />