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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.siaov.orp/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: Super Store Industries-Grocery Division (209)858-3365 October 06, 2017 Facility Address: CERS ID: 16888 McKinley Ave, Lathrop, CA 95330 10166883 Inspection Contact: Title: Phone: Scott Sommerfeld Facilities Manager (209) 858-3384 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 2361 -UST FACILITY Consent For: Consent Given By: 0 Inspection Z Photos ® Samples Scott Sommerfeld, Facilities Manager Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Zane Nimmo 06/02/2019 Troy Embry 06/21/2018 Service Technician Manufacturer's Training: VMI, 01/08/19;Veeder Root, 09/28117;Tank Tester, 01/08/17 CCR=California Cade 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 u V ❑R ❑COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑V ❑R u COS 103 HSC 25292.2 Current financial responsibility documents not submitted ❑V ❑R ❑COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ■V ❑R ■COS 105 CGR 2632(d)(1) Failed to have an approved UST monitoring plan ■V ❑R ■COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan u V ❑R ❑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 o R ❑COS 109 CCR 2637 Failed to test secondary containment o V ❑R o COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V ❑R o COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually o V u R in COS 112 HSC 25284.2 Failed to test spill containers annually o V o R o COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days o V o R o COS 114 CCR 26360 Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down o V o R o COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days c V o R o COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification o V ❑R o COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after in V in R o COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS 119 HSC 25299 Documents were falsified or misrepresented ❑V n R ❑COS 120 CCR 2635(d) Failed to submit UST Certification of Installaticn/Modification o V ❑R in COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report o V o R e COS 122 CCR 2631 Q) Failure to submit UST system component statement of compatibility for substance stored r❑V ❑R ❑COS On Site Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions n V ❑R ❑COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 112 years ❑V ❑R ❑COS 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site ❑V ❑R ❑COS FA0003833 PRO232523 SC001 10106/2017 EHD 23-01 Rev.09122116 Pagel of 4 Underground'Storage Tank Program OIR 9171 9690 0935 0151 6821 14