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A J OA U I Environmental Health Department <br /> COUNTY <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> SAFEWAY FUEL CENTER 42707 6425 N PACIFIC AVE, STOCKTON May 12, 2020 <br /> Other Violations <br /> 2010 1 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 110 CCR 2637(e), 2637(f) Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test. <br /> OBSERVATION: Secondary containment testing was performed on 9/17/19. Atest report has not been submitted <br /> to the EHD or the California Environmental Reporting System (CERS). <br /> REGULATION GUIDANCE: A copy of the 'Secondary Containment Testing Report Form' must be submitted within <br /> 30 days of the test. <br /> CORRECTIVE ACTION: Immediately provide this report to the EHD. <br /> This is a minor violation. <br /> 113 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> OBSERVATION: A monitoring system certification, leak detector testing, and spill container testing were performed <br /> on 5/14/2019. A test report has not been submitted to the EHD or the California Environmental Reporting System <br /> (CERS). <br /> REGULATION GUIDANCE: A copy of the test report must be submitted within 30 days of the test. <br /> CORRECTIVE ACTION: Immediately provide this report to the EHD. <br /> This is a minor violation. <br /> 202 CCR 2715(c)(3), 2715(c)(4) Failure to maintain the "Facility Employee Training Certificate" on-site (after October 1, <br /> 2018). <br /> OBSERVATION: The Facility Employee Training Certificate left blank date of training. <br /> REGULATION GUIDANCE: All site employees must be trained prior to taking responsibility as a facility employee if <br /> after October 1, 2018, or within 30 days of hire if prior to October 1, 2018. The Facility Employee Training <br /> Certificate shall contain accurate information for all employees trained. <br /> CORRECTIVE ACTION: Update the Facility Employee Training Certificate to contain the accurate information and <br /> submit a copy of the updated form to the EHD. <br /> This is a minor violation. <br /> FA0002409 PR0231211 SCO01 05/12/2020 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 5 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />