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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.sogov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> MY MINI MART 1 1756 N WILSON WAY, STOCKTON June 23, 2016 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 210 CCR 2715(e) Designated operator monthly inspection reports not maintained on site for at least 12 months. <br /> The 2016 designated operator monthly inspection reports(January-May)were not found on site. Designated <br /> operator monthly inspection reports for the previous twelve months shall be retained on site. The missing reports <br /> were provided by the technician when he arrived on site. Ensure that copies of the previous twelve months of <br /> designated operator monthly inspection reports are maintained on site. Submit copies to the EHD. <br /> This was corrected on site. <br /> This is a repeat violation, Class II. <br /> Overall Inspection Comments: <br /> An inspection checklist was provided to the facility operator on the day of inspection. The EHD has written the <br /> complete report which replaces the initial checklist. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, within 30 days of receiving the complete inspection report. <br /> Please be aware that as of January 1, 2014, facility operators are required to upload the following UST program <br /> documents into the California Environmental Reporting System (CERS): UST Monitoring Site Plan, UST <br /> Certification of Financial Responsibility, UST Response Plan, UST Letter from Chief Financial Officer(if <br /> applicable), and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator: Written <br /> Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br /> Documents reviewed: Designated operator (DO) monthly inspection reports, DO training log, CERS submittals, <br /> alarm history printouts, Maintenance records, Test results <br /> Documents provided: Return to Compliance Certification form <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br /> FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: Inspector: Inspector Phone: <br /> /l al Printed Name and Title: STACY RIVERA, Senior REHS (209)468-3440 <br /> Page 5 of 5 <br />