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AMENDED <br />SAN 1 O A Q U I N Environmental Health Department <br />C () U N I Y—— <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />HARNEY LANE AMPM <br />255 E Harney Ln, Lodi <br />June 20, 2018 <br />Overall Inspection Comments: <br />An inspection report was provided to the facility operator on the day of inspection. The report was amended by <br />the EHD on 07/11/18. The amended report replaces the initial report. Complete and submit a copy of the <br />Return to Compliance Certification form to the EHD with a statement documenting the corrective actions that <br />have been or will be taken for each violation, and any supporting paperwork within 30 days of this report. <br />Note: Monitoring system certification was completed on 06/29/2018. List of items that were tested: <br />1) All vacuum sensors. <br />2) Brine communication in all tank top sumps. <br />3) Vacuum communication in all UDC's and Vent sump. <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 />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />THIS FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received by: Date: <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />C� <br />AARON HANG, REHS <br />(209) 468-3453 <br />FA0021617 PRO537549 SC001 06/20/2018 <br />EHD 23-01 Rev. 10/31/2017 Page 5 of 5 Underground Storage Tank Program OIR <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />