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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, California 95202-3029 Telephone: (209)468-3420 Fax:(209) 468-3433 Web:www.sigov.org/ehd/unitiii.html CONTINUATION FORM Page: 3 of 3 OFFICIAL N P CT ON REPORT Date: 07/28/10 Facility Address: 440 W. DR. MARTIN LUTHER KING JR., BLVD., STOCKTON Program: UST SUMMARY OF VIOLATIONS CLASS I,CLASS II or MINOR-Notice to Comply) ROUTINE AND MONITORING SYSTEM CERTIFICATION UST INSPECTION REPORT #4. CURRENT FINANCIAL RESPONSIBILITY DOCUMENTS NOT ON FILE WITH THE EHD. UPON REVIEWING THE FILE FOR THIS FACILITY, CURRENT FIANANCIAL RESPONSIBILITY DOCUMENTS WERE NOT FOUND. PLEASE SUBMIT THE FINANCIAL RESPONSIBILITY DOCUMENTS TO THE EHD ANNUALLY. I PROVIDED A BLANK DOCUMENT AND THE OWNER FILLED IT OUT AND PROVIDED A COPY. CORRECTED ONSITE. NOTES: THE 87 UNLEADED SPILL BUCKET INITIALLY FAILED THE ONE HOUR HYDROSTATIC TEST. THE FILL CAP AND DRAIN VALVE WERE TROUBLE SHOOTED AND THE SPILL CONTAINER PASSED THE RETEST. ALSO THE SERVICE TECHNICIAN ONSITE HAD A VMI LEAK DETECTOR TEST UNIT THAT WAS NOT CALIBRATED WITHIN TWO YEARS AS REQUIRED BY THE MANUFACTUER. ANOTHER SERVICE TECHNICIAN BROUGHT A CALIBRATED TEST UNIT AND TESTED THE LEAK DETECTORS. THE OWNER STATED THAT HE MAY BUILD A NEW CONVENIENCE STORE ON THE NORTH WEST CORNER OF THE PROPERTY AND ADD TWO NEW DISPENSERS WHERE THE CURRENT STORE IS. A PERMIT WOULD BE REQUIRED TO MOVE OR ADD A MONITORING PANEL FOR THE UST SYSTEM. THE FACILITY FORM A WAS UPDATED ONSITE TO ADD THIS FACILITY'S BOE FUEL TAX NUMBER AND CHANGE THE FACILITY ADDRESS STREET NAME. ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE($115). THIS FAC!VV IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. EHD p tor: Received By: � � �� Title: EHD 23-02-003 Rev 06/01/10 CONTINUATION FORM