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Environmental Health Department <br />Underground Storage Tank Program Inspection Report <br />Facility Name:Facility Phone:Date: <br />(209) 943-2000 September 11, 2025 <br />CERS ID:Facility Address: <br />1909 CEMETERY LN, Stockton 10181391 <br />Phone: <br />(209) 689-5199 <br />Title: <br />Environmental Contact <br />Inspection Contact: <br />Michael Thomas <br />Inspection Type: <br />Routine <br />Program: <br />2361 - UST FACILITY <br />Consent Given By: <br />Charles Chapple, Director of Facilities Services <br />Consent For: <br />„ Inspection „ Photos † Samples <br />Service Technician Onsite: Exp. Date:Designated Operator: Exp. Date: <br />02/22/2026Edward Stearns05/08/2027Zane Nimmo <br />Service Technician Manufacturer's Training: <br />OPW, 03/10/2026; , ; , <br />OUT = Violation R = Repeat Violation COS = Corrected on site during inspection <br />1 CA Health and Safety <br />Code 25284; CCR 2711 <br />(d) <br />2030021 - Facility has a valid Permit to Operate from the CUPA † OUT † R † COS <br />2 CA Code of Regulations <br />2711 <br />2010010 - Complete and accurate UST Operating Permit Application has been <br />submitted. <br />„ OUT „ R † COS <br />3 CA Code of Regulations <br />2632(d)(1), 2634(d) <br />2010013 - Facility has submitted a complete and accurate UST Monitoring Plan.„ OUT „ R † COS <br />4 CA Code of Regulations <br />2632(d)(2), 2634(e) <br />2010014 - Facility has submitted a complete and accurate UST Response Plan.† OUT † R † COS <br />5 CA Code of Regulations <br />2632(d), 2641(h) <br />2030041 - A current facility plot plan is maintained and has been submitted † OUT † R † COS <br />6 CA Health and Safety <br />Code 25299(a)(8), 25299 <br />(b)(7) <br />2010006 - Owner/Operator has not made false statements, certifications, or <br />representations on documents <br />† OUT † R † COS <br />7 CA Code of Regulations <br />2715(a)(1)(B), 2715(a)(3) <br />2010003 - Owner/Operator submitted DO form and/or informed the CUPA of any <br />change(s) within 30 days (TCR 10) <br />† OUT † R † COS <br />8 CA Code of Regulations <br />2715(a)(1)(A), 2715(a)(2) <br />2010016 - "Underground Storage Tank Statement of Understanding and <br />Compliance Form" submitted (TCR 10) <br />„ OUT „ R † COS <br />9 CA Code of Regulations <br />2638, 2641(j), 2715(f) <br />2030002 - Leak detection equipment tested by qualified service technician every <br />12 months (TCR 9d) <br />† OUT † R † COS <br />10 CA Code of Regulations <br />2638(c), 2638(d) <br />2030074 - Annual Monitoring System Certification Form to the CUPA within 30 <br />days of completion of the test <br />„ OUT „ R † COS <br />11 CA Code of Regulations <br />2637(a-d), 2712(b)(1)(F) <br />2030048 - Sec containment testing conducted per requirements & records kept for <br />36 mths (TCR 9d) <br />† OUT † R † COS <br />12 CA Code of Regulations <br />2637(e), 2637(f) <br />2010009 - Secondary containment test results submitted to the CUPA within 30 <br />days after the test. <br />† OUT † R † COS <br />13 CA Code of Regulations <br />2637.1(d), 2637.1(e) <br />2010017 - Spill bucket testing results submitted to the UPA within 30 days of testing „ OUT † R † COS <br />14 CA Code of Regulations <br />2637.2(d&e), 2665(a&b) <br />2010018 - Overfill prevention equipment inspection report form submitted to the <br />UPA within 30 days <br />„ OUT „ R † COS <br />15 CA Code of Regulations <br />2636(f)(3), 2643(c)(3) <br />2030042 - Line integrity test completed on DW press piping every 12 mths if no fail <br />safe / + shutdown (TCR 9d) <br />† OUT † R † COS <br />16 CA Code of Regulations <br />2643(d), 2661(f) <br />2030050 - 0.1 gph piping test conducted on SW suction systems every 36 mths <br />and after piping repair (TCR 9d) <br />† OUT † R † COS <br />17 CA Code of Regulations <br />2643(e), 2661(f) <br />2030051 - 0.1 gph piping test conducted on SW gravity systems every 24 mths and <br />after piping repair (TCR 9d) <br />† OUT † R † COS <br />18 CA Code of Regulations <br />2663, 2712(b)(6) <br />2030029 - Tank lining inspected w/in 10 years of lining, every 5 years after, cert <br />submitted to CUPA (TCR 9c) <br />† OUT † R † COS <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />Page 1 of 7EHD - CUPA Inspection Report IS02 9/11/2025FA0004458 PR0231036 4549655