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San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sqoov.ora/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: Costco Wholesale#38 209 478-2040 March 03 2016 Facility Address: CERS ID: 1616 E Hammer Ln Stockton CA 95210 10146199 Inspection Contact Title: Phone: Dave La Roza Gas Station Attendant 209 475-9180 Inspection Type: Program: ROUTINE INSPECTION -CiDerating Permit 2371 - UST FACILITY- 1702 COMPLIANT Consent For: I Consent Given By: N Inspection ❑x Photos ❑x Samples I Sty Phornsavanh Gas Station Attendant Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Chad White 02/2812018 Laura Gomez 04/14/2017 Service Technician Manufacturers Training VMI 05/15117 VR 05/28/17 R=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284 No permit to operate o V ❑R o COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑V o R ❑COS 103 HSC 25292.2 Current financial responsibility documents not submitted o V ❑R o COS 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current ❑V o R o COS 105 HSC 25286(c) Current BOE number not submitted o V ❑R ❑COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD ❑V o R o COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R o COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing o V ❑R o COS 109 CCR 2637 Failed to test secondary containment o V o R ❑COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days o V ❑R ❑COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually o V oft ❑COS 112 HSC 252842 Failed to test spill containers annually o V ❑R ❑COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days o V o R ❑COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑V o R o COS 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days ❑V oft o COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V o R o COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well ❑V ❑R ❑COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test o V ❑R o COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days o V o R o COS 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after o V ❑R ❑COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS 122 HSC 25299 Documents were falsified or misrepresented o V ❑R o COS 123 CCR 2661 Permit to repair UST system not obtained ❑V o R ❑COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V ❑R o COS 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V o R o COS 126 HSC 25404(e)(4) Failed to report program data electronically o V ❑R ❑COS Page 1 of 4