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SANJOAQUII COUNTY Environmettal Health Department Facility Name: Facility Phone: Date: KISHIDA, GEORGE INC (209) 368-0603 November 17, 2017 Facility Address: CERS ID: 1725 ACKERMAN DR, LODI, CA 95240 10181383 Inspection Contact: Kelli Kishida Title: Secretary Phone: (209) 368-0603 Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 12361 - LIST FACILITY Consent For: Z Inspection El Photos El Sam les Consent Given By: Kelli Kishida, Secretary Service Technician Onsite: Exp. Date: Rhome Desbiens 01/05/2019 Designated Operator: Exp. Date: Rhome Desbians 01/27/2018 Service Technician Manufacturer's Training VMI, 01/09/19, Omntec, 10/26/17 CCR California Code of Regulations HSC Health and Safety Code CFR =Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection li'2 -_7 5"M Maw H 101 HSC 25284 Failure to obtain a valid permit to operate from the EHD including but not limited to unpaid fees Li V Ei R o COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system o V Li R o COS 103 HSC 25292.2, 25299.30 Current financial responsibility documents not submitted o V Li R Li COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current Ei V o R Ei COS 105 CCR 2632(d)(1), 2634(d) Failed to have an approved UST monitoring plan ❑ V o R c COS 106 CCR 2632(d)(2), 2634(e) Failed to have an approved UST response plan Li V E R Ei COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed a V o R ii COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing D V Lj R c COS 109 CCR 2637 Failed to test secondary containment ii V Ei R Li COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days o V o R Ei COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually o V Li R Li COS 112 HSC 25284.2 Failed to test spill containers annually Fi V Ei R o COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days Li V o R o COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑ V Li R o COS 115 CCR 2715(a) Failed to submit to EHD notification of designated operator identification or change Win 30 days ❑ V i -i R ii COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V o R ii COS 117 CCR 2663(h) Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after Ei V Li R c COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ii V Li R c COS 119 HSC 25299(a)(8), 25299(b)(7) Documents were falsified or misrepresented Li V c R o COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification Ei V c R ii COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report n V o R Ei COS 122 CCR 26310) Failure to submit and maintain UST system component statement of compatibility for substance stored o V ii R o COS Iwo maintain monitoring, maintenance, and follow up action records n4-7-1 n&nn flnO C r%4 C4 0 0') C n4 o V Ei R o COS 201 EHD 23-01 Rev. 09/22/16 1868 E. Hazelton Avenue I Stockton, California 9520,,' FA0003756 PR0231309 SCO01 11/17/2017 Page 1 of 4 Underground Storage Tank Program OIR I T 209 468-3420 1 IF 209 464-0138 1 www.sjcehd.com