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SAN J 0 A Q I I I Irl Environmental Health Department <br /> COUNT <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Supervalu 1 1990 N PICCOLI RD, STOCKTON November 08, 2021 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 207 CCR 2716(f)Failure to maintain designated operator inspection reports and all attachments on site for 36 months. <br /> OBSERVATION: The December 2020 designated operator monthly inspection report was not found on site. <br /> REGULATION GUIDANCE: Designated operator inspection reports prior to October 1, 2018 shall be retained on <br /> site for twelve months. Designated operator inspection reports on or after October 1, 2018 shall be retained on site <br /> for thirty-six months. <br /> CORRECTIVE ACTION: Locate and ensure that copies of the previous thirty-six months of designated operator <br /> inspection reports are maintained on site. <br /> This is a repeat violation, Class II. <br /> 208 CCR 2716(a-e) Failure to comply with the designated operator inspection requirements. <br /> OBSERVATION: Designated operator reports were not signed within the required time frame. The 09/07/2021 <br /> designated operator report was not signed by the owner/operator. <br /> REGULATORY GUIDANCE:Within 48 hours of the completion of the designated UST operator visual inspection, <br /> the designated operator shall sign and provide the owner or operator with a copy of the inspection report. Within 72 <br /> hours of being provided a signed copy of the report,the owner or operator shall provide a description of each <br /> corrective action taken or to be taken and shall sign and date the report, acknowledging the identified compliance <br /> issues. <br /> CORRECTIVE ACTION: Ensure all designated operator inspection reports are completed and signed within the <br /> required time frame in the future. <br /> This is a repeat violation, Class ll. <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 December 8, 2021. <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: inspection report, return to compliance certification, corrective action <br /> statement, and list of free CUPA classes. <br /> FA0003826 PR0231820 SCO01 11/08/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 6 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 />