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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.arplehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: Costco Wholesale#658 (209) 830-5340 September 21, 2017 Facility Address: CERS ID: 3250 W GRANT LINE RD,Tracy, CA 95377 10146285 Inspection Contact: Title: Phone: Keisha Smith TAssistant General Manager (209)830-5340 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 2361 - UST FACILITY Consent For: Consent Given By: 0 Inspection 0 Photos 0 Sample Tony Haggard, Supervisor Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Isaac Anderson 06/15/2018 Kaylynn Rammell 06/15/2018 Service Technician Manufacturer's Training: Veeder-Root, 09126118;VMI, 04/02/19 CCR=California Cade of Regulations HSC=Health and Safety Code CFR=Code of Faderal Regulations V-Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284 No permit to operate o V ❑R ❑COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V at R ❑COS 103 HSC 25292.2 Current financial responsibility documents not submitted ❑V in R ❑COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ❑V ❑R ❑COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan n V ❑R ❑CCS 106 CCR 2632(d)(2) Failed to have an approved UST response plan ❑V ❑R ❑COS 107 COR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑V ❑R ❑COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑V ❑R ❑COS 109 CCR 2637 Failed to test secondary containment ❑V ❑R ❑COS 11e CCR 2637(e) Failed to submit secondary containment test reportwithin 30 days ❑V ❑R o COS 111 CCR 2638(x) Failed to test monitoring and leak detection equipment annually ❑V ❑R ❑COS 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 ❑R in COS 115 CCR 2715(.) Failed to inform the El of designated operator identification or change within 30 days ❑V ❑R ❑COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R ❑COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑V ❑R o COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R o COS 119 HSC 25299 Documents were falsified or misrepresented ❑V o R n COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑V ❑R ❑COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report o V ❑R ❑COS 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored n V ❑R ❑COS On Site Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions c V Ei R ❑COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 112 years o V ❑R ❑COS 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site o V ❑R ❑COS FA0013810 PR0518288 SCO01 09121/2017 E H D 23-01 Rev.09/22116 Page 1 of 4 Underground Storage Tank Program OIR 9171 9690 0935 0152 1406 13