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Ogit1 SAN ;JOAQUIN Environmental Health Department C 0 U %J JC Y Unci rgVound Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: CHEVRON 4208117 " (209) 830=0370 February 07 , 2019 Facility Address: ID: 755 S TRACY BLVD, TRACY, CA 95376 CERS ERS ID: Inspection Contact: Title: Phone: Kristina Ramirez Station manager (209) 830"0370 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY Consent For: Consent Given By: ❑ Inspection ❑ Photos ❑ Samples Kristina Ramirez. Station manager Service Technician Onsite: Exp, Date : Designated Operator: Exp, Date: Jesus Saldivar 06/16/2019 Rayana Black 01 / 19/2020 Service Technician Manufacturer's Training : Veeder Root, 05/01 /19, VMI , 11 /20/19, SB , 01 /31 /20 CCR = Title 23 California Code or Ragulaltons HSC = eahh and Safely Cade CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection fie Review 101 HSC 25284 Failed to Obtain a permit to operate from the EHD Including but not limited to unpaid permit fees a V o R a COS 102 HSC 25284(a) (3) (A)/(B) No written agreement between lank owner and tank operator to monitor the tank system o V u R ; COS 103 HSC 25292. 21 25293, 30 Failure to submit and maintain complete and current financial responsibility documents a V u R n COS 104 CCR 2711 UST operating permit application for facility and tank Information not submitted or current V a R a COS 105 CCR 2632(d)(1 ), Failed to have an approved UST monitoring plan o V a R a COS 2634 (d) 106 CCR 2632(d)(2) , Failed to have an approved UST response plan 0V - R n COS 2634 (e) 107 CCR 2632(d)( 1 )(C) Plot plantsite map not submitted or failed to completely show where monitoring is performed n V - R COS 108 CCR 2837, 2638(e), Failed to notify the EHD 43 hours prior to conducting testing ❑ V R a COS 2643(g) 109 CCR 2637(a-d), 2712 Faded to test secondary containment, or railed to maintain lest records for 36 months in V zi R e COS 110 CCR 2637 (e), 2637(f) Faded to submit ' Secondary Containment Testing Report Form' within 30 days atter the lest „ V , R COS 111 CCR 2638(a) 8 (b) , Failed to test monitoring and leak detection equipment annually o V R o COS 2641 6) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance e V o R a COS 113 CCR 2638 (c) , 2638(d) Failure to submit " Monitoring System Certification Form" within 30 days of completion of the test a V c R COS 114 CCR 2836(Q (3), 2643(c) No 0. 1 gph annual line integrity test for pressurized piping or within 30 days after repair a V o R a COS (3) 115 CCR 2715 (a) (1 ) (B), " Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days o V o R o COS 2715(a) (3) 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification o V o R a COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining, recordkeeping, and inspection requirements a V o R c COS 118 CCR 2715(a) ( 1 )(A) , Failure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form' a V c R n COS 2715(a) 2) 119 HSC 25299(a)(8) , Documents were falsified or misrepresented o V r R n COS 25299(b) (7) 120 CCR 2635(d) Felled to submit UST Certification of Installalion(Modificalion n V ❑ R uCOS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report o V n R o COS 122 CCR 2631 , 2640. 1 , Failure to submit and/or maintain documentation regarding compatbikty for UST system components c V R COS 2665 , 2711 FA0007938 PR0508090 SC001 02/0712019 EHD 2MI Rev 09/28x2018 Page 1 of 6 Underground Storage Tank Program OIR 1868 E Hazelton Avenue I Stockton . California 95205 1 T 209 468-3420 1 F 209 464 -0138 I www s)cehd. com