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S u N J 0 A Q U I N Environmental Health Department <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> QUIK STOP MARKET#2076" (209)948-6731 July 01,2019 <br /> Facility Address: CERS ID: <br /> 1030 S OLIVE ST, STOCKTON, CA 95205 10180695 <br /> Inspection Contact: Title: Phone: <br /> Roger Batra Environmental Contact (510)445-2285 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION-Operating Permit 2361 -UST FACILITY <br /> Consent For: Consent Given By: <br /> 0 Inspection ❑x Photos ❑x Samples Harpal Harit, Franchise <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> Maxwell Hines 11/09/2019 Curtis Carpenter 11/28/2020 <br /> Service Technician Manufacturer's Training: <br /> OPW,01/01/21;VR, 03/28/20;VMI,07/13/19 <br /> CCR=Title 23 California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> File Review <br /> 101 HSC 25284;CCR Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees o V o R o COS <br /> 2711(d) <br /> 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system o V o R o COS <br /> 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents in V o R o COS <br /> 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V o R o COS <br /> 105 CCR 2632(d)(1), Failed to have an approved UST monitoring plan ■V o R o COS <br /> 2634(d) <br /> 106 CCR 2632(d)(2), Failed to have an approved UST response plan o V o R o COS <br /> 12634(e) <br /> 107 CCR 2632(d),2641(h), Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R o COS <br /> 2711(a) <br /> 108 CCR 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing o V o R o COS <br /> 2643(g) <br /> 109 CCR 2637(.-d),2712 Failed to test secondary containment,or failed to maintain test records for 36 months o V o R o COS <br /> 110 CCR 2637(e),2637(f) Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test o V o R o COS <br /> 111 CCR 2638,26416). Failed to test monitoring and leak detection equipment every 12 months o V o R o COS <br /> 2715(f) <br /> 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance o V o R o COS <br /> 113 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test ■V o R o COS <br /> 114 CCR 2636(f)(3),2643(c) No 0.1 gph annual line integrity test for pressurized piping,or within 30 days after repair in V o R o COS <br /> 1(3) <br /> 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator Identification Form"not submitted within 30 days o V o R o COS <br /> 2715(a)(3) <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification in V o R o COS <br /> 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining,recordkeeping,and inspection requirements o V o R c COS <br /> 118 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" ■V o R o COS <br /> 2715(a)(2) <br /> 119 HSC 25299(a)(8), Documents were falsified or misrepresented c V in R o COS <br /> 125299(b)(7) <br /> 120 1 CCR 2635(d) Failed to submit UST Certification of Installation/Modification c V o R o COS <br /> 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS <br /> FA0001060 PR0231704 SCO01 07/01/2019 <br /> EHD 23-01 Rev.09/28/2018 Page 1 of 6 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 />