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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.s*qov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: WINE COUNTRY STATION7-ELEVEN 209 369-3633 Octobei-09, 2015 CERS ID: Facility Address: 1111 E KETTLEMAN LN LODI CA 95240 10182257 Inspection Contact: Title: Phone: Nim-al it Badial Mana er 209 369-3633 Inspection Type: Program: ROUTINE INSPECTION -O eratin Permit 2361 - UST FACILITY Consent For: Consent Given By: O Inspection N Photos O Samples Nirmaliit Badial Manager Service Technician Onsita Exp.Date: Designated Operator: Exp.Date: David Winkler 03/03/2016 Guadalupe R Sanchez 01/31/2017 Service Technician Manufacturer's Training VMI, 11/10/15 Veeder Root 02/10/16 SWRCB 03/31/17 CCR=California ode of Regulations HSC=Health and a(ety Cotle CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corected on site during inspection File Review 101 HSC 25284 No permit to operate n V u R ❑COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑V ❑R o 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 HSC 25286(c) Current BOE number not submitted ❑V ❑R o COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD ❑V o R ❑COS 107 CCR 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 2¢37 Failed to test secondary containment ❑V ❑R ❑COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V ❑R ❑COS 111 CCR 2638(a) 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 shutdown ❑V ❑R ❑COS 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days ❑V u R ❑COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R ❑COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well ❑V ❑R n COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑V ❑R ❑COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ❑V ❑R ❑COS 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑V ❑R ❑COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS 122 HSC 25299 Documents were falsified or misrepresented o V ❑R ❑COS 123 CCR 2661 Permit to repair UST system not obtained ❑V o R ❑COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V ❑R ❑COS 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS Received by Inspector: Phone: Dom: (initial): �� ARIS VELOSO, Senior REHS (209)468-3453 10/09/2015 Page 1 of 5