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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUN r <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> KPMC MANAGEMENT INC, DBA:ARCO 900 S CHEROKEE LN, LODI October 27, 2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 109 CCR 2715(a)(1)(B), 2715(a)(3) Failure to submit"Designated Underground Storage Tank Operator Identification <br /> Form"within 30 days. <br /> OBSERVATION:A new designated operator,Amy Winkler, began conducting inspections on 07/21/2021 and <br /> notification was not provided to the EHD within 30 days of the change. <br /> REGULATION GUIDANCE: The owner or operator shall submit a"Designated Underground Storage Tank Operator <br /> Identification Form"no later than 30 days after any change in the designated UST operator(s). <br /> CORRECTIVE ACTION: This violation was corrected on site. <br /> This is a repeat violation, Class II. <br /> 115 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, leak detector testing, and spill container testing was <br /> performed on 10/15/2020 and a test report was submitted on 12/08/2020, 24 days 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 2637.2(d&e), 2665(a&b) Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within <br /> 30 days. <br /> OBSERVATION: The overfill prevention inspection was performed on 01/18/2021 and a test report was submitted <br /> on 09/01/2021, 6 months 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 minor violation. <br /> FA0000556 PR0231841 SCO01 10/27/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 5 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.sjgov.org/EHD <br />