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SAN J O A Q U I N Environmental Health Department COUNTY ZIogq `"7 0 Greotness crows here . RECEIVED JAN 17 2019 Al ss�jC is l ' Underground Storage Tank Program InspectioReport Facility Name: Facility Phone: Date: CHEVRON STATION #210997* (209) 599-0149 January 17, 2019 Facility Address: CERS ID: 1442 Colony Dr, RIPON , CA 95336 10184539 Inspection Contact: Title : Phone: ssssssssss Charles Bittle Environmental contact (925) 842-9002 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2361 as UST FACILITY Consent For: Consent Given By: 0 Inspection Z Photos 21 Samples Karina Gordillo, Manager Service Technician Onsite: Exp. Date: Designated Operator: Exp, Date: Jesus Saldivar 06/ 16/2019 Rayana Black 01 / 19/2020 Service Technician Manufacturer's Training: Veeder Root, 05/01 /19; VMI , 11 /20/19 ; SB , 01 /31 /20 CCR = Title 23 California Code of Regulations HSC = Health and Safety Coda CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection Fil R e 101 HSC 25284 Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees o V ❑ R o COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system o V o R o COS 103 HSC 25292.2, 25299. 30 Failure to submit and maintain complete and current financial responsibility documents o V o R n COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V ❑ R o COS 105 CCR 2632(d)( 1 ) , Failed to have an approved UST monitoring plan o V ❑ R o COS 2634(d) 106 CCR 2632(d)(2), Failed to have an approved UST response plan o V ❑ R o COS 2634(e) 107 CCR 2632(d)(1 )(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R o COS 108 CCR 2637, 2638(e), Failed to notify the EHD 48 hours prior to conducting testing o V o R ❑ COS 2643(g) 109 CCR 2637(a•d), 2712 Failed to test secondary containment, or failed to maintain test records for 36 months o V o R ❑ COS 110 CCR 2637(e), 2637 (f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test o V o R ❑ COS 111 CCR 2638(a) & (b), Failed to test monitoring and leak detection equipment annually o V ❑ R o COS 26410) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V o R ❑ COS 113 CCR 2638(c) , 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test o V o R o COS 114 CCR 2636(f)(3), 2643(c) No 0. 1 gph annual line integrity test for pressurized piping, or within 30 days after repair ❑ V o R o COS (3) 115 CCR 2715(a)(1 )(B), "Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days o V o R o COS 2715 (a)(3) 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification o V o R o COS 117 CCR 2663, 2712(b) (6) Failure to comply with tank lining, recordkeeping, and inspection requirements o V o R o COS 118 CCR 2715(a)( 1 )(A) , Failure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form" o V o R o COS 2715(a)(2) 119 HSC 25299(a)(8), Documents were falsified or misrepresented o V o R o COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V ❑ R o COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑ V ❑ R ❑ COS 122 CCR 2631 , 2640. 1 , Failure to submit and/or maintain documentation regarding compatibility for UST system components o V o R o COS 2665, 2711 FA0013918 PR0518458 SCO01 01117/2019 EHD 23,01 Rev 09128/2018 _ Page 1 of 6 Underground Storage Tank Program 0 I 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 4683420 1 F 209 464-0138 1 www. sjcehd . com