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lo' San Joaquin County ' <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.Sb ov.or /ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: Facility Address: <br />Costco Wholesale #1031 sate: <br />2440 DANIELS ST Manteca 1AUQL <br />Item # <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Remarks <br />201 <br />HSC 25290.1(e) VPH monitoring of the interstitial spaces of the UST system is not maintained. <br />The 87A STP sump product S9 vacuum sensor failed when tested. The interstitial space of the UST shall be <br />maintained, as designed, under constant vacuum Such that a breach in the primary or secondary containment is <br />detected before the hazardous substance is released into the environment. The sensor was replaced and retested <br />during the inspection. A "UST Retrofit Verification with Inspector Already Onsite" form has been completed and <br />provided to the operator and contractor. This was corrected on site. <br />This is a repeat violation, Class 11. <br />Overall Inspection Comments: <br />Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br />documenting the corrective actions that have been or will be taken for each violation, and any supporting <br />paperwork, by September 18, 2015 . <br />Please be aware that as of January 1, 2014, facility operators are required to upload the following UST program <br />documents into the California Environmental Reporting System (CERS): UST Monitoring Site Plan, UST <br />Certification of Financial Responsibility, UST Response Plan, UST Letter from Chief Financial Officer (if <br />applicable), and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator. Written <br />Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br />NOTES: <br />- Provided UST Retrofit Verification With Inspector Already Onsite for 87A Product S9 Vacuum Sensor <br />replacement. <br />- Verified all sensor at lowest. <br />- Provided RTC. <br />THIS F ILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S�CURRENT HOURLY RATE. <br />Received By Received By (printed name and title): Date. <br />(signature): Stacy Rodriques, Gas Station Attendent8_127_1 <br />Inspector <br />Inspector (printed name and title): Ins <br />(signature): FATPNAH ZAREEF, REHS Inspector Phone: <br />2111 - <br />(209)953-7311 <br />Page 5 of 5 <br />