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SAN JOA U I N Environmental Hea' fth .De r mint C (_) U NTYff 1 ' f 7E 45 f) fi? IVt tt f Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date : ER Vine Stockton (209 ) 537-0723 June 28 , 2019 Facility Address : CERS ID: 4733 S HWY 99 , STOCKTON , CA 95215 10399867 Inspection Contact: Title: Phone: Bonnie Garber Administrator (209 ) 537-9396 Inspection Type: Program : ROUTINE INSPECTION - Operating Permit 12361 - UST FACILITY Consent For: Consent Given By: 0 Inspection 0 Photos 0 Sam les Bonnie Garber, Adminsitrator Service Technician Onsite: Exp, Date : Designated Operator: Exp. Date: Mario Romero 10/ 13/2020 Jeff Barten 02/06/2020 Service Technician Manufacturer's Training VMI , 03/14/20 ; VR , 02/ 12/20 ; Opw(SB ) , 05/02/20 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 inspectio File Review 101 HSC 25284; CCR Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ❑ V ❑ R ❑ COS 2711 (d) 102 HSC 25284(a) (3) (A)/(B) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292 . 21 25299 . 30 Failure to submit and maintain complete and current financial responsibility documents ■ V ❑ R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ❑ V ❑ R ❑ COS 105 CCR 2632 (d) ( 1 ) , 2634(d Failed to have an approved UST monitoring plan ❑ V ❑ R ❑ COS 106 CCR 2632 (d) (2) , 2634(e Failed to have an approved UST response plan ■ V ❑ R ❑ COS 107 CCR 2632(d) , 2641 (h) , Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑ V ❑ R ❑ COS 2711 a 108 CCR 2637, 2638(e) , Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 2643(g) 109 CCR 2637(a-d) , 2712 Failed to test secondary containment , or failed to maintain test records for 36 months ❑ V ❑ R ❑ COS 110 CCR 2637(e) , 2637 (f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test ❑ V ❑ R ❑ COS 111 CCR 2638 , 26410) , Failed to test monitoring and leak detection equipment every 12 months ❑ V ❑ R ❑ COS 2715 (f) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance ❑ V ❑ R ❑ COS 113 CCR 2638(c) , 2638(d) Failure to submit " Monitoring System Certification Form " within 30 days of completion of the test ❑ V ❑ R ❑ COS 114 CCR 2636(f) (3) , 2643 (c) No 0 . 1 gph annual line integrity test for pressurized piping , or within 30 days after repair ❑ V ❑ R ❑ COS (3) 115 CCR 2715 (a) ( 1 ) (B) , " Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days ❑ V ❑ R ❑ COS 2715(a) (3) 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ 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" ❑ V ❑ R ❑ COS 2715 (a) (2) 119 HSC 25299(a) (8) , Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 25299 b 7 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑ V ❑ R ❑ COS 122 CCR 2631 , 2640 . 1 , Failure to submit and/or maintain documentation regarding compatibility for UST system components ❑ V ❑ R ❑ COS 2665 , 2711 FA0003924 PR0232510 SC001 06/28/2019 EHD 23-01 Rev, 09/28/2018 Page 1 of 6 Underground Storage Tank Program OIR 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468 -3420 1 F 209 464 -0138 1 www. sjcehd. com