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SAN JOAQUIN Environmental Health Department Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: AM PM HAMMER/15 FOOD #83113 1(209)474-9125 Mav 30, 2025 SUMMARY OF VIOLATIONS (CLASS I, CLASS II,or MINOR-Notice to Comply) Item# Remarks 7 CA Code of Regulations 2715(a)(1)(B), 2715(a)(3) 2010003 - Owner/Operator submitted DO form and/or informed the CUPA of any change(s)within 30 days (TCR 10) OBSERVATION: The Designated Operator Identification Form used is outdated. REGULATION GUIDANCE: Owners or operators of underground storage tank systems shall submit through the California Environmental Reporting System or a local reporting portal, a signed statement indicating that the owner or operator understands and is in compliance with all applicable underground storage tank requirements, and identifying the designated UST operator(s)for each facility owned or operated at all of the following times: (1)Within 30 days of installing an underground storage tank system, the owner or operator shall submit all of the following: (A)A signed "Underground Storage Tank Statement of Understanding and Compliance Form," located in Appendix X, indicating that the owner or operator understands and is in compliance with all applicable underground storage tank requirements; and (B)A"Designated Underground Storage Tank Operator Identification Form," located in Appendix XI, identifying the designated UST operator(s)for the facility. (2)The owner or operator shall submit a signed "Underground Storage Tank Statement of Understanding and Compliance Form," upon any change in the owner or operator which previously submitted the signed "Underground Storage Tank Statement of Understanding and Compliance Form," no later than 30 days after the change. (3)The owner or operator shall submit a "Designated Underground Storage Tank Operator Identification Form" upon any change of designated UST operator(s)to the local agency no later than 30 days after the change. CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov and upload the notification identifying all the designated operators for this facility. This is a Repeat (Class 2)Violation. 53 CA Health and Safety Code 25292.2; CCR 2711(a)(11) 2010007 - Submitted/maintained current Cert of Financial Responsibility/mech of financial assurance (TCR 11) OBSERVATION: Financial responsibility documents have not been submitted to the EHD. The most recent financial responsibility documents in CERS are dated 7/25/22. REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/, and upload the required documents. -his is a Repeat (Class 2)Violation. 56 CA Code of Regulations 2716(a-e) 2030013 - DO inspections completed at least every 30 days and meet all requirements (TCR 12) OBSERVATION: The designated operator inspections for the following months were performed more than 30 days after the previous inspection: - Initial inspection on 4/30/24, next inspection performed on 6/1/24 (32 days) - Initial inspection on 6/30/24, next inspection performed on 7/31/24 (31 days) - Initial inspection on 9/28/24, next inspection performed on 10/31/24 (33 days) - Initial inspection on 12/30/24, next inspection performed on 1/31/25 (32 days) - Initial inspection on 2/27/25, next inspection performed on 3/30/25 (31 days) REGULATION GUIDANCE: The designated operator visual inspections shall be conducted within 30 days or less of the previous inspection. CORRECTIVE ACTION: Ensure that all designated operator inspections are performed within the required time frames. This is a Repeat (Class 2)Violation. EHD-CUPA Inspection Report IS01 Page 5 of 7 FA0001877 PR0232224 4513845 5/30/2025 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD