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SKJOAQUIN �TZ- Environmental Health Department Greatriegs grows here, 3-�! FaclRty Name: BILLS 76 Facility Phone: Date: Facllity Address: (209)367-7516 February 19,2020 633 E VICTOR RD,LODI,CA 95240 CERS ID. Inspection Contact 10180603 Title: Phone: Shawn on Type; Manager (209)712-7359 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 2361-UST FACILITY Consent For. Consent Given By; ©Inspection El Photos O Samples Shawn Sodhi,Manager Service Technician Onsite: Exp.Date: Designated Operator: Ems,Date: David Winkler 01/22/2022 Alex Jabbari 10/01/2020 Service Technician Manufacturees Training: TT,3/3112020;VR,02/09122;VMI, 11107121;SB, 11/29/20 CCR=TRIe 23 California Code of Regula.... HSC=Fieahh and Safety Code CFR=Cade of Federal Regulations V=Vion COS CarnaUed on site ring mspecn io aUon R Repeat violation a du on 41asK 101 HSC 25284;CCR Failed to obtain a permit to operate from the EHO including but not limited to unpaid permd fees ❑V n R ❑COS 2711(d 102 HSC 25284(a)(3)(A)I(B) No written agreement between tank owner and tank operator to monitor the tank system n V o R ❑COS 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents ❑V ❑R ❑COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current n V a R o COS 105 CCR 2692(d)(1), Failed to have an approved UST monitoring plan o V a R o COS 2634(d 106 CCR 2632(d)(2), Failed to have an approved UST response plan n V o R a COS 2634(e) 107 CCR 2632(d),2641(h), Plot plan/site map not submitted or failed to completely show where monitoring is performed o V u R o COS 2711 a) 108 CCR 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing ❑V n R a COS 2643(g) 109 CCR 2637(a-d),2712 Failed to test secondary containment,or failed to maintain test records for 36 months o V a R ©COS 110 CCR 2637(e),2637(Q Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test OV OR o COS 111 CCR 2638,26410, Failed to test monitoring and leak detection equipment every 12 months a V o R o COS 2715(0 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance n V o R a COS 113 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test o V ❑R o COS 114 CCR 2636(0(3),2643(c) No 0.1 gph annual fine integrity test for pressurized piping,or within 3D days after repair 0 V o R ❑COS (3) 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator ldenfificaton Form"not submitted within 30 days 0 V ❑R o COS 2715(a)(3) 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification a V o R n COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining,recordkeeping,and Inspection requirements a V o R o COS 118 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" ❑V ❑R o COS 2715(!q(2) 119 HSC 25299(.)(8), Documents were falsified or misrepresented o V ❑R n COS 25298(b 120 CCR 2635(d) Failed to submit UST Certification of InstallatlonlModlAcation a V u R o COS 121 CCR 2712(0 Failure to implement corrections and submit written response within 30 days of receiving the report o V o R o COS 122 CCR 2631,2640.1, Failure to submit andlor ms)ntain documentation regarding compatibility for UST system components n V a R o COS 2665,2711 FAQDD0483 PRO232519 SCDol 021192020 EHD 23-01 Rev.9208019 Page 1 of 5 Underground Storage Tank Program O1R 1868 E.Hazellon Avenue I Stockton,California 952051 T 209 468-34201 F 209 464-0138 1 www.sicehd.com