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SAN J O A R N Environmental Health Department <br /> i y �V <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> HARNEY LANE AM PM 255 E Harney Ln, Lodi June 16, 2020 <br /> Other Violations <br /> 2010 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 113 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> OBSERVATION:Annual monitoring system certification and leak detector testing was performed on 6/19/2019 and <br /> a test report was submitted on 8/5/2019, one month late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a repeat violation, Class II. <br /> 118 CCR 2715(a)(1)(A),2715(a)(2) Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> OBSERVATION: The Statement of Understanding and Compliance does not contain owner/operator information. <br /> REGULATION GUIDANCE: This form must be uploaded to the California Environmental Reporting System (CERS). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and update and upload the Underground Storage Tank Statement of Understanding and <br /> Compliance Form for this facility. <br /> This is a minor violation. <br /> 123 CCR 2637.1(d), 2637.1(e)Failure to submit the"Spill Container Testing Report Form"within 30 days after the test. <br /> OBSERVATION: Spill container testing was performed on 6/19/2019 and a test report was submitted on 8/5/2019, <br /> one month late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a repeat violation, Class II. <br /> FA0021617 PR0537549 SCO01 06/16/2020 <br /> EHD 23-01 Rev.9/20/2019 Page 4 of 7 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />