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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd/unitiii.htmi <br /> CONTINUATION FORM Page: 3 of 3 <br /> OFFICIAL INSPECTION R P RT Date: 03/18/11 <br /> Facility Address: USA Gas Station #68152 401 W. Kettleman Lane Lodi, CA 95240 Program: UST <br /> SUMMARY OF VIOLATIONS <br /> CLASS 1,CLASS 11,or MINOR-Notice to Comply) <br /> On site to conduct a re-inspection and witness the annual monitoring system certification testing of the <br /> line leak detectors. <br /> 25. Annual monitoring system certification testing of the line leak detectors were last performed on <br /> 2-24-10 and was completed on 3-18-11, one month past due. This test is required once every 12 <br /> months. Take all necessary precautions to ensure testing is performed in a timely manner. <br /> Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br /> each violation was corrected, including supporting documentation, by 4-18-11. <br /> Note: <br /> The VMI LDT-890 leak detector tester equipment used during the 2-23-11 annual monitoring system <br /> certification testing did not have a current certification sticker from the manufacturer affixed to it. The <br /> testing of the leak detectors on 2-23-11 cannot be accepted since documentation from the manufacturer <br /> verifying that the particular VMI LDT-890 leak detector tester equipment used on 2-23-11 has been <br /> certified by the manufacturer is not available. The identification number assigned to the VMI LDT-890 <br /> leak detector tester equipment used on 2-23-11 is Service Station Systems asset#SSS00897. <br /> The VMI LDT-890 leak detector tester equipment used during today's testing did have a current <br /> certification sticker from the manufacturer affixed to it. Recalibration for this VMI LDT-890 leak detector <br /> tester is not due till 8-4-11. <br /> Today's re-inspection is billable at the Environmental Health Department's current hourly rate. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE($122). <br /> THIS FACIL IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Ins Received By: Title: <br /> 1?� <br /> EHD 23-02-003 Rev 08/10/10 CONTINUATION FORM <br />