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SAN <br /> J D �� I Environmental Health Department <br /> COUNTY— <br /> Underground <br /> OU T — <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Mossdale Chevron 444 W MOSSDALE RD, LATHROP June 13, 2019 <br /> Item# Remarks <br /> 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents. <br /> An approved copy of financial responsibility documents were not available for inspection. Financial documents on <br /> site are outdated.A copy of these documents shall be accessible on site at all times. Immediately locate and retain <br /> a copy on site. <br /> This is a minor violation. <br /> 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current. <br /> The UST Tank Information forms for the 87, 91 and diesel tanks are not current in CERS.Tank manufacturer <br /> information is missing.Any change of information must be updated in CERS within 30 days of the changes. <br /> Immediately log into CERS, update the required information, and submit for review by the EHD. <br /> This is a Class II violation. <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed. <br /> An accurate UST Monitoring Site Plan was not submitted.A site plan must be submitted identifying the location of <br /> the annular space sensor. Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/and upload a copy of the UST Monitoring Site Plan. <br /> This is a minor violation. <br /> 109 CCR 2637(a-d),2712 Failed to test secondary containment, or failed to maintain test records for 36 months. <br /> According to the designated operator's monthly inspection reports and test results onsite, secondary containment <br /> testing was last performed on 3/27/2016 and was due by March 2019 . Testing has not been completed and is 3 <br /> months past due. Secondary containment testing is required once every 36 months. Immediately schedule this test <br /> and provide 48 hours notification to the EHD. <br /> This is a Class II violation. <br /> 113 CCR 2638(c), 2638(d)Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> Annual monitoring system certification, leak detector testing, and spill container testing was performed on 6/13/2018 <br /> and a test report was submitted on 12/14/18, 6 months late. A copy of the test report must be submitted within 30 <br /> days of the tests. Take all necessary precautions to ensure testing and submittal of test reports are performed in a <br /> timely manner. <br /> This is a minor violation. <br /> FA0000212 PR0231692 SCO01 06/13/2019 <br /> EHD 23-01 Rev.09/28/2018 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 />