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SAN J O A Q U I N Environmental Health Department <br /> -COUNTY- <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> BlackHawk Petroleum Inc. 5611 E WATERLOO RD, STOCKTON July 29, 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS ll,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 320 CCR 2635, 2637.2, 2665, 2712 Failure to comply with the installation, inspection, or record keeping of the overfill <br /> prevention. <br /> Overfill prevention testing was conducted on October 16, 2018. This testing was required to be conducted by <br /> October 13,2018. Ensure all future testing is conducted within required time frames. <br /> This is a Class II violation. <br /> Overall Inspection Comments: <br /> The monitoring system certification was conducted today, 7/29/2019 and was not fully witnessed by EHD. <br /> Looked inside all sumps and UDCs. Verified sensor locations and piping communication. An inspection checklist <br /> was provided to the facility operator on the day of inspection. The EHD has written the complete report which <br /> replaces the initial checklist. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 8/28/2019. <br /> Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate ($152). To schedule an <br /> appointment, please call (209) 468-3420. <br /> Documents provided: <br /> -Return to compliance certification <br /> -EHD class schedule <br /> -Gasoline Advertising Signs <br /> -Certification of Financial Responsibility Form <br /> -Letter from Chief Financial Officer Form <br /> -Response Plan Form <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: July 29, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: SHEWIT WOLDEAREGAY, EHS Trainee (209)468-0216 <br /> lubna hussain, owner <br /> FA0002160 PR0231764 SC001 07/29/2019 <br /> EHD 23-01 Rev.09/28/2018 Page 6 of 6 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />