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EHD 23-01 Rev. 09/22/16 FA0003611 PR0231127 SC001 05/09/2017 Page 1 of 6 Underground Storage Tank Program OIR San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.segov.org/ehd �tl'1�E�t'tif©'1�� Tat1iC Ptl�dlramClIfll`#C}C� » » , . Facility Name: PARKWOODS GAS & FOOD Facility Phone: (209) 951-9707 Date: May 09, 2017 Facility Address: 1612 W HAMMER LN, STOCKTON, CA 95209 CERS ID: 10181241 Inspection Contact: Jesse Tiwana Title: Ownerr Phone: (209) 482-2580 Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 2361 - UST FACILITY Consent For: ® Inspection ® Photos ® Samples I Consent Given By: I Jesse Tiwana, Owner Service Technician Onsite; David Winkler Exp. Date: 03/01/2018 Designated Operator: Kaylynn Rammell Exp. Date: 06/15/2018 Service Technician Manufacturer's Training Veeder Root, 02103/18; VMI, 11/12/17; Tank Tester,03/31/20 CCR=California Codeo egu ations HSC=Health and Safety Code CFR= Code of a era Regulations V = Violation R = Repeat violation COS = Corrected on-site during inspection r " 7,77FFire Rere,4Own _ 101 HSC 25284 No permit to operate ■ V ❑ R ❑ COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ■ V ❑ R ❑ COS 103 HSC 25292.2 Current financial responsibility documents not submitted ■ V ■ R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ■ V ■ R ❑ COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ■ V ❑ R ❑ COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan ■ V ❑ R ❑ COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■ V ■ R ❑ COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ R ❑ COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑ V ❑ R ❑ COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑ V ❑ R ❑ COS 112 HSC 25284.2 Failed to test spill containers annually ❑ V ❑ R ❑ COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ❑ V ❑ R ❑ COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑ V ❑ R ❑ COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days ❑ V ❑ R ❑ COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑ V ❑ R ❑ COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑ V ❑ R ❑ COS 119 HSC 25299 Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ■ V ❑ R ❑ COS 122 �4 ". x 201 CCR 2631 Q) f'$.rz .. i ,. r^: �✓ r CCR 2712(b) Failure to submit UST system component statement of compatibility for substance stored a g, r i�—qi i- �r 9:x �s, r a �.. ... _ r �«ylyF YL-?-.✓ �+ x �i �� X��9j _J" xSit E�'C ... _er ili"'. t{t (01S Sr'ynr _t alb= r _ ll,�_/ dkiroi�{�i%. Ifo}f tet, l+xs .s".,. ..0 _r�,rn?, , 1.'=w.,ty Y.1 /r _" n£�*� ,. ,, c d .' _ „_ _':, .,. 5 Qy r,E Failed to maintain alarm logs and/or records of follow up actions ❑ V ❑ R ❑ COS ,� .. .✓� �w'€' 3�-i q P X xva y1,aii' ❑ V ❑ R ❑ COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years ❑ V ❑ R ❑ COS EHD 23-01 Rev. 09/22/16 FA0003611 PR0231127 SC001 05/09/2017 Page 1 of 6 Underground Storage Tank Program OIR