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Page t of 4 4 San Joaquin County K Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www sjoov ora/ehd Underground Storage Tank Program Inspection Report Facility Phone: Date: Facility Name: 209 981-7464 Au ust 21 2015 Miracle Mile Market CERS ID: Facility Address: 10180779 244 W HARDING WAY STOCKTON CA95204 Phone: Inspection Contact: Pew Tide: 209 981-6862 Sarab it Singh Manager Inspection Type: Program: 2361 -UST FACILITY ROUTINE INSPECTION -O eratin Permit Consent For: Consent Given By: O Ins on O Photos 0 Samples Sarab it Sin h Mana er Exp Date: Service Technician Onsite: Exp. Data: Designated Operator: 03/10/2016 Dave Winkler 03/03/2016 Dave Winkler Service Technician Manufacturers Training V02/l0/VaMoI 11/10/s5 HTT 0H3t1/a17 Safety =Code ofFeerl Regulations c mi6 V Viol ton R =Repeat violation cos = Corrected on site during Inspection File Review o V ❑ R o COS 101 HSC 25284 No permit to operate 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system n V n R ❑COS 103 HSC 25292.2 Current financial responsibility documents not submitted ■ V ❑ R ❑ COS Permit Application for Facility and Tank information not submitted or current ❑ V ❑ R ❑ COS Operating (c) Current BOE number not submitted ❑ V ❑ R ❑ COS W271UST Monitoring and response plans not current or approved by the EHD ❑V ❑ R ❑ COS d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑ V ❑ R ❑ COS (f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing n V o R in COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ R ❑COS containment test report within 30 days ❑ V ❑ R ❑COS 110 CCR 2637(e) Failed to submit secondary and leak detection equipment annually ❑ V ❑ R ❑COS 111 CCR 2638(a) Failed to test monitoring 112 HSC 25284.2 Failed to test spill containers annually ❑ V ❑ R ❑COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ■ V ❑ 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 in R ❑ COS the EHD of a change of designated operator within 30 days o V o R o COS 115 CCR 2715(a) Failed to inform 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R n COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1 000'of a public well ❑ V ❑ R ❑ COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑ V ❑ R ❑ COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ❑ V ❑ R ❑ 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 in R o 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 ❑ V ❑ R in COS 123 CCR 2661 Permit to repair UST system not obtained ❑ V ❑ R ❑ COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V ❑ R in COS 125 CCR 2712 Failed to submit a written response within 30 days of receiving an inspection report ❑ V ❑ R ❑ COS Received by Inspector: CINDY VO, EH Specialist ICAY Phone: (209) 468-8257 08/21/2015 (initial): Page t of 4