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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.smoov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> Costco Wholesale#38 (209) 478-2040 March 02, 2017 <br /> Facility Address: CERS ID: <br /> 1616 E Hammer Ln, Stockton, CA 95210 10146199 <br /> Inspection Contact: Title: Phone: <br /> Sty Phornsavanh Attendent (209)478-2040 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION -Operating Permit 2371 - UST FACILITY- 1702 COMPLIANT <br /> Consent For: Consent Given By: <br /> (9Inspection 0Photos ZSamples Sty Phornsavanh, Attendent <br /> Service Technician Onsite Exp.Date: Designated Operator: Exp.Date: <br /> Chad White 02/09/2018 Kaylynn Rammell 06/15/2018 <br /> Service Technician Manufacturer's Training <br /> Veeder Root,05/28/17; VMI, 05/05/17 <br /> ccR=California Codeo egu a ions HSC=Health and SafetyC3de CFR=Codeo a era Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> File Review <br /> 101 HSC 25284 No permit to operate -V _r R ❑COS <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V in R ❑COS <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted ❑V ❑R ❑COS <br /> 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ❑V ❑R ❑COS <br /> 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ❑V ❑R n COS <br /> 106 CCR 2632(d)(2) Failed to have an approved UST response plan ❑V ❑R ❑COS <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■V ❑R ❑COS <br /> 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing in V ❑R ❑COS <br /> 109 CCR 2637 Failed to test secondary containment o V ❑R o COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V ❑R ❑COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually n V ❑R in COS <br /> 112 HSC 25284.2 Failed to test spill containers annually ❑V ❑R ❑COS <br /> 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ❑V ❑R ❑COS <br /> 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑V ❑R o COS <br /> 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days ❑V n R ❑COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R ❑COS <br /> 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑V ❑R ❑COS <br /> 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS <br /> 119 HSC 25299 Documents were falsified or misrepresented ❑V ❑R ❑COS <br /> 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑V ❑R c COS <br /> 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS <br /> 122 CCR 2631II) Failure to submit UST system component statement of compatibility for substance stored ❑V ❑R o COS <br /> 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions o V DR ❑COS <br /> 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years ❑V ❑R ❑COS <br /> 203 CCR 2712(b) Failed to maintain records of monitoring, repair,lining,and upgrades on site ❑V ❑R ❑COS <br /> FA0001705 PR0518624 SCO01 03/02/2017 <br /> EHD 23-01 Rev.09/22/16 Page 7 of 4 Underground Storage Tank Program OIR <br />