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0 SAN JOAQUIN COUNTY 0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd/unitiii.html <br />CONTINUATION FORM <br />Page: 3 of 3 <br />OFFICIAL INSPECTION REPORT <br />Date: 06/14/11 <br />Facility Address: SMK Chevron 25651 N. Hwy 99 Acampo, CA 95220 <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />CLASS I CLASS II, or MINOR -Notice to Comply) <br />On site to conduct a routine inspection and witness the annual monitoring system certification testing. <br />4. Financial responsibility documents have not been submitted to the EHD. The most recent copy <br />submitted was dated 6-10-10. Current financial responsibility documents are required to be submitted <br />annually. The current financial responsibility documents were submitted during the inspection. Repeat <br />violation. Repeat Violation. Corrected on Site. <br />23c. The designated operator failed to check and note the correct test dates for the secondary <br />containment testing on the past twelve designated operator monthly inspection reports. On the <br />designated operator reports from June 2010 through June 2011, the secondary containment test is listed <br />as 7-9-08. On the reports from June 2010 through May 2011 it should be listed as 6-9-08. On the report <br />of June 2011 it should be listed as 6-9-11. During the monthly inspection, the designated operator shall <br />check that all required testing and maintenance for the UST system have been completed and document <br />the dates they were done. Ensure that designated operators performing monthly inspections at this <br />facility are including all of the required information on the reports. Repeat Violation. <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 7-14-11. <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 FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />Received By: w <br />Title: <br />EHD 23-02-003 Rev 08/10/10 CONTINUATION FORM <br />