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A N J O A Q U I N AMENDED Environmental Health Department <br /> 9/11/2025 <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> 1909 CEMETERY LN, Stockton September 11, 2025 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I, CLASS II, or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 8 CA Code of Regulations 2715(a)(1)(A), 2715(a)(2) 2010016 - "Underground Storage Tank Statement of Understanding <br /> and Compliance Form" submitted (TCR 10) <br /> OBSERVATION: The Underground Storage Tank Statement of Understanding and Compliance Form lists the incorrect <br /> address of the UST. <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 address on the Underground Storage Tank Statement of Understanding and <br /> Compliance Form for this facility. <br /> This is a Repeat(Class 2)Violation. <br /> 10 CA Code of Regulations 2638(c), 2638(d) 2030074 -Annual Monitoring System Certification Form to the CUPA within <br /> 30 days of completion of the test <br /> OBSERVATION: Annual monitoring system certification and leak detector testing was performed on 09/10/2024 and a <br /> test report was submitted on 11/19/2024, 40 days late. <br /> REGULATION GUIDANCE: A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are performed in <br /> a timely manner. <br /> This is a Repeat(Class 2)Violation. <br /> 13 CA Code of Regulations 2637.1(d), 2637.1(e) 2010017 - Spill bucket testing results submitted to the UPA within 30 <br /> days of testing <br /> OBSERVATION: Annual spill container testing was performed on 9/10/2024 and a test report was submitted on <br /> 11/19/2024, 40 days late. <br /> REGULATION GUIDANCE: A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are performed in <br /> a timely manner. <br /> This is a (Minor)Violation. <br /> 14 CA Code of Regulations 2637.2(d&e), 2665(a&b) 2010018 - Overfill prevention equipment inspection report form <br /> submitted to the UPA within 30 days <br /> OBSERVATION: An overfill prevention equipment inspection was performed on 09/10/2024 and a test report was <br /> submitted on 11/19/2024, 40 days late. <br /> REGULATION GUIDANCE: A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are performed in <br /> a timely manner. <br /> This is a Repeat(Class 2)Violation. <br /> EHD-CUPA Inspection Report IS02 Page 5 of 6 FA0004458 PR0231036 4549655 9/11/2025 <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 />