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TRANSMISSION VERIFICATION REPORT <br />TIME 11/07/2012 12:49 <br />NAME SJC EHD UNIT 3 <br />FAX 2094683433 <br />SER.# BROM7F534354 <br />DATE,TIME <br />11/07 12:46 <br />FAX N0./NAME <br />915305424413 <br />DURATION <br />00:03:12 <br />PAGE(S) <br />09 <br />RESULT <br />OK <br />MODE <br />STANDARD <br />) 334-0975 <br />ECM <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 952023029 <br />Telephone: (209) 468-3420 Fax: (209) 488-3433 Web: www.sigo` v.ora/ hdlunitifi.f h'N <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />am: Flag City Chevron <br />Add�ss: 5421 Capital Ave. Lodi, CA 95242 <br />Date: Sep 28, 2012 <br />Pacllfty, <br />Amrit Gill <br />Title: employee <br />) 334-0975 <br />c4 <br />Inspefon <br />XRQutine XMor tering System C Cenifmwn G instailation Complaint - ID#: (I Other. <br />T <br />Type: <br />Type: <br />(Authority HSC 2$289) <br />Singh Title: emplOVee <br />Consentfor, XInspeetion )KSarnoing )Photos Granted by:Harnek <br />Monitoring Veeder-Root TLS -350 <br />piping XPressuri2ed 0 Suction !`1 Gravity <br />rer#ill <br />PXMecnartical nAudlgle1WSUa1 <br />Prevention: <br />Panni: <br />system: <br />UST <br />7 <br />~ ^ <br />- - <br />- - - - _._ <br />----------- <br />-----.w__- <br />-- <br />Product <br />- a7 -octane - <br />H7 -octans - <br />- -DSL <br />�1-octaneDea <br />Alex ��IJbafi <br />ICG �• October 201 <br />Violations: [:I M1 -Release Det"m OM2 -1 elea a Prevcrfion XM3- Bath <br />Operator. <br />Operator- <br />Date: <br />On Site Service <br />James Day <br />100 Exp.r Manutactursrs UMI 5-31-14, t/I12-13-13 <br />5-12-13 <br />Technician: <br />Date: Training: <br />VIOLATIONS <br />C7 <br />C2 M Code Section <br />t1 = aifomia Health and Code; CCR R Caetomla Code of ations <br />Cl = Class i nidation; C2 = Class 2 vlQrat[on' M = Minor violation <br />'z;P <br />•t <br />r ,r �L, '4,4:;�s rr!' .4t �., ;I+,'r. Y .S'' 'F=y.✓�, y d rf w9 -l' .x ik i' .r, i„ (,�, v' h',' �'h'u:'v <br />101 <br />HSC 25284 <br />No permit to operate <br />102 <br />HSC 25404.5 <br />Annual operating tea not paid <br />No written agreement between the person that tie operating permit was Issued to and tie tank operator to <br />103 <br />MSC 25284(a)(3) <br />monitor the tank s stem <br />104 <br />HSC 25292.2 <br />Current financial responsibility documents not on file with the Environmental Health Department (EHD) <br />105 <br />CCR 2711 <br />Current Unified Program Consolidated Forms not on file with the EHD (Facility and tank fprn <br />106 <br />CCR 2832(b) <br />Monitoring Program Monitoring & Response Plans) is not current or approved the EHf) <br />107 <br />CCR 2B32(d)(1)(C) <br />Plot plantsite map not submitted or fails to completely show where monitoring is performed <br />Secondary containment (a) test not performed; (e) test report not submitted within 30 days; test nodficat)on <br />108 <br />CCR 2637 <br />not provided to the EHD at least 48 hours prior to conducting,the test <br />Monitoring equipment certification: (a) not performed annually; (d) test report not submitted within 30 days; <br />109 <br />CCR 2638 <br />(e) test notification not provided to the EHD at toast 48 hours prior to conducting an Installation, repair, <br />re IaceMnt, callbratipn or certification <br />110 <br />HSC 25291 (f) <br />Annual line leak detector test not performed IM1) <br />111 <br />HSC 25284.2 <br />Annual spill containment testing not performed <br />112 <br />CCR 2638(1)(4) <br />An(wai line tightss netest not performed if positive shutdown or fail safe not prew.nt ifcH) <br />113 <br />CCR 2715(a) <br />Failed to inform the EHD of a change of designated operator within 30 days <br />114 <br />CCR 2715(b) <br />i3esignated operator does not possess a current ICC CA UST S tam Operator certtflcatlon <br />Repair for piping mg tested for tightness after Completion of the repair ptawAnt to (W) <br />115 <br />CCR 26N(K)aorrt <br />