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S A N 10 A Q U I N Environmental Health Department <br /> CP22 - UST FULL Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> TIWANA GAS&FOOD 209 477-3111 June 02 2025 <br /> Facility Address: CERS ID: <br /> 1210 E HAMMER LN STOCKTON CA 95210 10181355 <br /> inspection Contact Title: Phone <br /> Owner 209 482-2580 <br /> Inspection Type: Program: <br /> Routine 2361 US T I AGILI T Y <br /> Consent For: Consent Given By: <br /> In i h Jesse liwana Owner <br /> Service Technician Onalte: Exp.Dah: Designated operator: Exp.Date: <br /> ��a� (1'^tire 1/ 01202G David Winkler 2/22/2026 <br /> Service Technician ManufacUxeft Training: <br /> OPW 3 '02026 VR, 3;10'2026;VMI_ 11/12/2025;Bravo, 1/19/2027 <br /> OUT-Violation R-Repeat violation C08-Corrected on site during inspection <br /> 1 !CA Health and Safety 2030021-Facility has a valid Permit to Operate from the CUPA OUT ,R COS <br /> (Code 25284.CCR <br /> 2711�d` <br /> 2 CA Code of Regulations 2010010-Complete and accurate UST Operating Permit Application has been submitted. ■OUT a R -,COS <br /> 12711 <br /> 3 CA Code of Regulations 2010013-Facility has submitted a complete and accurate UST Monitoring Plan. o OUT ;R COS <br /> 2632(d)1),2634�d! <br /> 4 CA Code of Regulations 2010014-Facility has submitted a complete and accurate UST Response Plan. ❑OUT R -,'-OS <br /> 2632,d1,Z',2634(e) <br /> 5 iCA Code of Regulations 2030041-A current facility plot plan is maintained and has been submitted ❑OUT R COS <br /> 2632 d. 2641(h' <br /> 6 ICA Health and Safety 201100D6-Owner/Operator has not made false statements,certifications,or representations on ❑OUT R =COS <br /> ICode 25299(ax8), documents <br /> '25299(b)(7) <br /> 131-Code of Regulations 2010003-Owner/Operator submitted DO form and/or informed the CUPA of any change(s)within ■OUT ■R z COS <br /> 15(ah1)(8),2715(a) 30 days(TCR 10) <br /> 8 r;,A Code of Regulations 2010016-"Underground Storage Tank Statement of Understanding and Compliance Form" c OUT R 2 COS <br /> 2 15(ax1)(A),2715(a) submitted(TCR 10) <br /> I(2) <br /> 9 ICF Code of Regulations 2030002-Leak detection equipment tested by qualified service technician every 12 months(TCR =OUT =R =COS <br /> 12638,2641(;_2715(f) d) <br /> 10 CA Code of Regulations 2030074-Annual Monitoring System Certification Fort to the CUPA within 30 days of completion of ❑OUT =R =COS <br /> 12638(c;,2638(d) the test <br /> 11 ICA Code of Regulations 2030048-Sec containment testing conducted per requirements&records kept for 36 mths(TCR c OUT =R COS <br /> 2637(a-d),2712(bx1) ) <br /> i(F) <br /> 12 CA Code of Regulations 201o0D9-Secondary containment test results submitted to the CUPA within 30 days after the test. c OUT =R =COS <br /> 2637(e).2637(f) <br /> 13 CA Code of Regulations 2010017-Spin bucket testing results submitted to the UPA within 30 days of testing OUT R COS <br /> 2637.1(d),2637.1(a) <br /> 14 CA Code of Regulations 2010018-Overfill prevention equipment inspection report form submitted to the UPA within 30 days ❑OUT R c COS <br /> 26372(d&e), <br /> 2665(a&b) <br /> 15 CA Code of Regulations 2030042-Line integrity test completed on DW press piping every 12 mths if no fail safe/+ ❑OUT e R ❑COS <br /> 2636(fX3),2643(cx3) shutdown(TCR 9d) <br /> 16 CA Code of Regulations 2030050-0.1 gph piping test conducted on SW suction systems every 36 mths and after piping ❑OUT ❑R ❑COS <br /> 2643(d),2661(f) repair(TCR 9d) <br /> FA0003730 PR0231125 SC001 06/02/2025 <br /> EHD Rev.12/06QO21 Page 1 of 7 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 />