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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.sigov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> 7-ELEVEN INC#17334 209) 951-6745 October 05, 2016 <br /> Facility Address: CERS ID: <br /> 4501 N PERSHING AVE, Stockton, CA 95207 10165815 <br /> Inspection Contact: Title: Phone: <br /> Ramey Gill Manager (209) 951-6745 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION -Operating Permit 2361 - UST FACILITY <br /> Consent For: Consent Given By: <br /> 0 Inspection O Photos 0 Samples Ramey Gill, Manager <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> Stephen Willems 06/03/2018 Kaylynn Rammell 06/15/2018 <br /> Service Technician Manufacturer's Training <br /> Veeder Root, 07/07/18; TLDT5000, 12/30/16 <br /> UQK=California Codeo egu a ions HSC=Health and Safetye CFR=Codeo a eral Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> File Review <br /> 101 HSC 25284 No permit to operate D V o R o COS <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system D V D R D COS <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted in V o R D COS <br /> 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current n V in R ❑COS <br /> 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ■V of R D COS <br /> 106 CCR 2632(d)(2) Failed to have an approved UST response plan D V n R n COS <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑V D R D COS <br /> 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing D V ❑R ❑COS <br /> 109 CCR 2637 Failed to test secondary containment ■V D R D COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V D R in COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑V ❑R D COS <br /> 112 HSC 25284.2 Failed to test spill containers annually n V ❑R in 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 D COS <br /> 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days D V D R ❑COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R D 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 D 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 D 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 j CCR 26310) Failure to submit UST system component statement of compatibility for substance stored o V o R ❑COS <br /> On Site Records <br /> 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions o V o R D 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 a R n COS <br /> FA0002479 PR0231233 SCO01 10/05/2016 <br /> EHD 23-01 Rev.09/22/16 Pagel of 5 Underground Storage Tank Program OIR <br />