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A J OA U I Environmental Health Department <br /> COUNTY <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CHEVRON STATION 4209167 1234 E YOSEMITE AVE, MANTECA February 11, 2021 <br /> Other Violations <br /> 2010 1 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 122 CCR 2712(f) Failure to implement corrections and submit written response within 30 days of receiving the report. <br /> OBSERVATION: An inspection was last done on 02/07/2020 and an inspection report was issued identifying <br /> information to be submitted to bring this site into compliance. This information was required to be submitted by <br /> 03/08/2020. This information was received On 10/19/2020, seven months late resulting in a non-compliant status for <br /> this facility. <br /> REGULATION GUIDANCE: An operator that receives an inspection report shall have 30 days to implement the <br /> corrections specified in the inspection report and comply with permit conditions. The corrective action shall include <br /> all of the recommendations made in the report. The operator shall submit a written response that includes a <br /> statement documenting corrective actions taken or proposing corrective actions which will be taken. <br /> CORRECTIVE ACTION: Ensure that a written response documenting corrective actions taken or proposed is <br /> submitted and all corrections implemented within 30 days of receiving an inspection report. <br /> This is a Class II violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 03/13/21 . <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209) 468-3420. <br /> Documents provided during inspection: Return to compliance certification form, corrective action statement form <br /> and a list of approve CUPA free training classes. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: <br /> Date: February 11, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EH Specialist (209) 616-3049 <br /> Theresa Rodriguez, Store Manager <br /> FA0012532 PR0516248 SCO01 02/11/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 4 of 4 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 />