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SHADOW? _C0UNTY.— Grc r,ws5 grow here, Environantai Health Department lJrdergroud Storage'T�lr>��c Program Inspect�on;Report 1 . H . Facility Name: Plaza liquor and Gas Facility Phone: (209) 369-1960 Date: October 11, 2018 Facility Address: 2420 W TURNER RD, LODI, CA 95242 CERS ID: 10181595 Inspection Contact: Ruppi Padda Title: Operator Phone: (209) 914-8735 Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 12361 - UST FACILITY Consent For: ❑x Inspection ❑x Photos Z Samples Consent Given By: Shawn Sodhi, Manager Service Technician Onsite: Exp. Date: Zane Nimmo 06/02/2019 Designated Operator: Exp. Date: Alex Jibbari 10/01/2020 Service Technician Manufacturer's Training: Veeder Root, 09/28/19; VMI, 01/08/19; Tank Tester, 03/31/19 CCR = Title 23 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 E Ftte Reutev i' 101 HSC 25284 Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees o V o 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 o R o COS 103 HSC 25292.2, 25299.30 Failure to submit and maintain complete and current financial responsibility documents o V o R o COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V o R c COS 105 CCR 2632(d)(1), 2634(d) Failed to have an approved UST monitoring plan o V o R o COS 106 CCR 2632(d)(2), 2634(e) Failed to have an approved UST response plan o V o R c COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R o COS 108 CCR 2637,2638(e), 2643(g) Failed to notify the EHD 48 hours prior to conducting testing o V o R c COS 109 CCR 2637(a -d), 2712 Failed to test secondary containment, or failed to maintain test records for 36 months o V o R o COS 110 CCR 2637(e), 2637(f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test o V o R D COS 111 CCR 2638(a) & (b), 26410) Failed to test monitoring and leak detection equipment annually o V o R o COS 112 1 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V o R o COS 113 CCR 2638(c), 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test o V o R o COS 114 CCR 2636(f)(3), 2643(c) (3) No 0.1 gph annual line integrity test for pressurized piping, or within 30 days after repair o V o R o COS 115 CCR 2715(a)(1)(B), 2715(a)(3) "Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days o V D R D COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification D V o R o COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining, recordkeeping, and inspection requirements o V o R o COS 118 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form" o V o R D COS 119 HSC 25299(a)(8), 25299(b)(7) Documents were falsified or misrepresented o V o R o COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V o R o COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS 122 CCR 2631, 2640.1, 2665, 2711 Failure to submit and/or maintain documentation regarding compatibility for UST system components o V o R o COS FA0004139 PR0231382 SCO01 10/11/2018 EHD 23-01 Rev. 09/28/2018 Page 1 of 4 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com