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SAN <br /> J A QV Environmental Health Department <br /> LOU NI <br /> G(eoo)ess grows here, <br /> CP22 - UST FULL Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> GRANT LINE SHELL 209 836-8908 May 01 2025 <br /> Facility Address: CERS ID: <br /> 2375 W GRANT LINE RD TRACY CA 95376 10181399 <br /> Inspection Contact: Title: Phone: <br /> 209 836-8908 <br /> Inspection Type: Program: <br /> Routine 12361 - UST FACILITY <br /> Consent For: Consent Given By: <br /> ❑x Inspection ❑x Photos ❑ Samples Komal Bhardwa' Manager <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> Junior Saldivar 05/16/2025 Marcus Villabrille 07/07/2025 <br /> Service Technician Manufacturer's Training: <br /> VR, 03/31/2027; SB, 01/07/2027; LID, 11/07/2025 <br /> OUT=Violation R=Repeat violation COS=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 ❑R ❑COS <br /> 2711 <br /> 3 CA Code of Regulations 2010013-Facility has submitted a complete and accurate UST Monitoring Plan. ■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 ❑COS <br /> 2632(d)(2),2634(e) <br /> 5 CA 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 CA Health and Safety 2010006-Owner/Operator has not made false statements,certifications,or representations on ❑OUT ❑R ❑COS <br /> Code 25299(a)(8), documents <br /> 25299(b)(7) <br /> 7 CA Code of Regulations 2010003-Owner/Operator submitted DO form and/or informed the CUPA of any change(s)within ❑OUT ❑R ❑COS <br /> 2715(a)(1)(B),2715(a) 30 days(TCR 10) <br /> (3) <br /> 8 CA Code of Regulations 2010016-"Underground Storage Tank Statement of Understanding and Compliance Form" ❑OUT ❑R ❑COS <br /> 2715(a)(1)(A),2715(a) submitted(TCR 10) <br /> (2) <br /> 9 CA Code of Regulations 2030002-Leak detection equipment tested by qualified service technician every 12 months(TCR ❑OUT ❑R ❑COS <br /> 2638,26416),2715(f) 9d) <br /> 10 CA Code of Regulations 2030074-Annual Monitoring System Certification Form to the CUPA within 30 days of completion of ■OUT ■R ❑COS <br /> 2638(c),2638(d) the test <br /> 11 CA Code of Regulations 2030048-Sec containment testing conducted per requirements&records kept for 36 mths(TCR ❑OUT ❑R ❑COS <br /> 2637(a-d),2712(b)(1) 9d) <br /> (F) <br /> 12 CA Code of Regulations 2010009-Secondary containment test results submitted to the CUPA within 30 days after the test. ❑OUT ❑R ❑COS <br /> 2637(e),2637(f) <br /> 13 CA Code of Regulations 2010017-Spill bucket testing results submitted to the UPA within 30 days of testing ■OUT ❑R ❑COS <br /> 2637.1(d),2637.1(e) <br /> 14 CA Code of Regulations 2010018-Overfill prevention equipment inspection report form submitted to the UPA within 30 days ❑OUT ❑R ❑COS <br /> 2637.2(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 ❑R ❑COS <br /> 2636(f)(3),2643(c)(3) 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 /> FA0003772 PR0232469 SCO01 05/01/2025 <br /> EHD Rev.12/06/2021 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 />