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RECEIVED FEB 0 6 2020 C O V ` yG SAN J O A Q U I N Environmental Health Department C0l. if\\ITY usc Underground Storage Tank Program Inspection Report Facility Name : Facility Phone: Date: CHEVRON #208117* * (209 ) 830-0370 February 06 , 2020 Facility Address: CERS ID: 755 S TRACY BLVD, TRACY, CA 95376 10182313 Inspection Contact: THie: Phone: Teena Townsell Station Manager (209) 830-0370 inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY Consent For: Consent Given By: 0 Inspection O Photos ❑ Samples Teena Townsell , Station Manager Service Technician Onsite: Exp, Date: Designated Operator: Exp. Date: Brent Bowen 06/23/2021 Erick Aranda 03/ 12/2021 Service Technician Manufacturer's Training : VMI , 07/09/21 , OPW, 01 /05/20, VR, 04/21 /21 CCR = Title 23 californ;a Code of Regulatio HSC = Health and Safety Code CFR = Code of Federal egulations V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284; CCR Failed to obtain a permit to operate from the END including but not limited to unpaid permit fees ❑ V ❑ R o COS 2711 (d) 102 HSC 25284(a)(3)(A)I(B) No written agreement between tank owner and lank operator to monitor the tank system o V o R ❑ COS 103 HSC 25292. 21 25299. 30 Failure to submit and maintain complete and current financial responsibility documents o V o R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V o R o COS 105 CCR 2632(d) ( 1 ) , Failed to have an approved UST monitoring plan o V o R o COS 2634 (d) 106 CCR 2632(d)(2) , Failed to have an approved UST response plan o V o R o COS 2634(e) 107 CCR 2632(d) , 2641 (h) , Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑ V o R o COS 2711 (a) 108 CCR 2637 , 2638(e), Failed to notify the EHD 48 hours prior to conducting testing ❑ V o R o COS 2643 (8) 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(0 Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test o V o R o COS 111 CCR 26381 26410), Failed to test monitoring and leak detection equipment every 12 months ❑ V ❑ R ❑ COS 2715(0 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V o R ❑ COS 113 CCR 2638(c) , 2638(d) Failure to submit "Monitoring System Certification Forrri' within 30 days of completion of the test a TO R o COS 114 CCR 2636(0(3) , 2643(c) No 0. 1 gph annual line integrity test for pressurized piping , or within 30 days after repair o V o R ❑ COS (3) 115 CCR 2715(a) ( 1 )(B) , "Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days n V ❑ R o COS 2715 (a)(3) 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R n COS 117 CCR 2663 , 2712(b)(6) Failure to comply with tank lining , recordkeeping , and inspection requirements ❑ V ❑ R ❑ COS 118 CCR 2715(a)(1 )(A) , Failure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form" o V c R o COS 2715(a)(2) 119 HSC 25299(a) (8) , Documents were falsified or misrepresented ❑ V o R ❑ COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of InstallatiorvModification o V e R o COS 121 CCR 2712(0 Failure to implement corrections and submit written response within 30 days of receiving the report ❑ V o R o COS 122 CCR 2631 , 2640 . 11 Failure to submit andlor maintain documentation regarding compatibility for UST system components o V o R o COS 2665, 2711 FA0007938 PRO508090 SC001 02/06/2020 EHD 23-01 Rev 9120/2019 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 corn