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M15CITY OF STORMWATER DIVISION
<br /> ST0CKT0.%%T
<br /> COMMERCIAL INSPECTION FORM
<br /> Inspector Name: Akin Fayehun Date and Time of Inspection: 9/25/2018 12:00:OOP
<br /> Commercial Business Type: Retail Gas Outlets
<br /> Occupier of Property Information: Property Owner Info if Different(Responsible Party):
<br /> Name of Business: Costco Wholesale Name of Business: NJ INVESTMENTS STOCKTON LLC
<br /> Contact Person: Charile Morris Contact Person:
<br /> Street: 1624 E HAMMER LN CT Street: 1156 TANGLEWOOD WAY
<br /> City: Stockton State: CA Zip: 95210 City: SAN MATEO State: CA Zip: 94403
<br /> Phone Number: 209-478-2040 Phone Number:
<br /> Email Address: w038mgr3@costco.com Email Address:
<br /> Relationship to Property Owner(i.e.Self,Tenant): Mailing Address: 1156 TANGLEWOOD WAY
<br /> Mailing Address: 1624 E HAMMER LN CT City: SAN MATEO State: CA Zip:94403
<br /> City: STOCKTON State: CA Zip:95210
<br /> Storm Drains: Score (1-5): 1
<br /> (Onsite Storm drains,Storm drain contents,Storm drain treatment maintenance documentation(private),Storm drain labeling)
<br /> Inspection consisted of:Observing storm drains,contents of the storm drains,Onsite treatment devices and reviewing maintenance history of the
<br /> treatment device,if storm drains are correctly labeled.
<br /> Inspector Comments:
<br /> Facility Structure, Parking Lots,Yards, Etc.: Score (1-5): 1
<br /> (Excessive parking lot staining,Soil Staining,Oily parts or equipment,Rusted equipment,Equipment maintenance conducted in open areas,
<br /> Equipment fueling,Dust suppression,etc.)
<br /> Inspection consisted of:Observing Parking Lots for staining,facility yards for staining and other potential pollution contributors,any dust generation
<br /> where dust suppression is necessary,uncovered equipment maintenance,oily;wrecked or discarded equipment,etc.
<br /> Inspector Comments:
<br /> Waste Management: Score(1-5): 1
<br /> (Trash receptacles covered&plugged,Operational Trash,Personal Trash,Floatables,pet waste management,staining around trash receptacles,
<br /> etc.)
<br /> Inspection consisted of:Observinq site trash,trash receptacles and surrounding area,and pet waste management,leakinq or heavily damaqed
<br /> Inspector Comments:
<br /> Fluid Management: Score (1-5): 3
<br /> (Chemicals,On-site Fueling stations,Spills of any kind,Containers,Secondary confinement applications,spill kits)
<br /> Inspection consisted of:Observing fueling station miss-management,on-site fluid containers;labeling practices and secondary confinement uses:
<br /> Inspector Comments:Fuel spill into storm drain No visible sheen on effected drain and connected drain.Spill kit used to clean
<br /> surface spill according to manager.Patriot Environmental cleaned the spill in storm drain.
<br /> Illicit Connections or Fluids exiting (present or past)facility: Score (1-5): 3
<br /> (Illicit Storm drain connection internal to the facility,Fluids exiting the facility current,Fluids exiting the facility past signs)
<br /> Inspection consisted of:Observing the facility for fluids exiting the facility,staining from fluids exiting the building,asking facility operator if any
<br /> known interior drain connections exist if so inspectinq them,lookinq for indications of possible interior drain connections
<br /> Inspector Comments:Fuel spill in immediate storm drain.Fluid did not reach connecting storm drains.Confirmed during physical
<br /> inspection.
<br /> INSPECTION FEE: $191.00 INSPECTION RESULT: Fail
<br /> Signature of Facility Representative*: Name: (printed) Charlie Morris Date: 9/25/2018
<br /> `Note:Signature of facility representative does not attest to content of report,only that the inspection occurred)
<br /> The City of Stockton Inspector is required to photograph items/areas that would contribute to a violation of City Stormwater Code(Title 13).
<br /> Inspections Line Item Scores 3-5 result in a failed Inspection and could result in a Notice of Warning,Notice of Violation,Cease and Desist,or a Stop Work Order
<br /> All Line Items scoring a 3-5 result in photograph(s)being taken of the area of concern to document the potential violation
<br /> City of Stockton I Stormwater Divison 12500 Navy Drive,Stockton,CA,95206 1209.937.8155
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