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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 /> HARNEY LANE AM PM 255 E Harney Ln, Lodi June 21, 2021 <br /> Single-Walled Non-Pressurized Piping <br /> 404 CCR 2643(e),2661(f) Failure to conduct 0.1 gph test on single-walled gravity piping biennially or post repair(pre-1984) ❑V ❑R ❑COS <br /> Other Violations <br /> 2010 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 /> 107 HSC 25292.2; CCR 2711(a)(11)Failure to submit and maintain complete and current financial responsibility <br /> documents. <br /> OBSERVATION: The Letter of Chief Financial Officer is inaccurate. Line 4 of the Letter from the Chief Financial <br /> Officer does not equal lines 2 and 3. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/, and upload the required documents. <br /> This is a repeat violation, Class ll. <br /> 110 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> OBSERVATION: The Underground Storage Tank Statement of Understanding and Compliance Form is incomplete. <br /> The owner/operator information section was left blank. <br /> REGULATION GUIDANCE: This form must be uploaded to the California Environmental Reporting System (CERS). <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov and upload the Underground Storage Tank Statement of Understanding and Compliance <br /> Form for this facility. <br /> This is a repeat violation, Class II. <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 06/16/2020 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 July <br /> 16, 2020. This information has not been received resulting in a non-compliant status for 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 /> FA0021617 PR0537549 SCO01 06/21/2021 <br /> EHD 23-01 Rev.9/16/2020 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.sjgov.org/EHD <br />