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San Joaquin County Environmental Health Department 1868 East HazeIton Avenue, Stockton, Telephone: (209) 468-3420 Fax: (209) 468-3433 California 95205-6232 Web: www.sjgov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: CHEVRON STATION #99840* Facility Phone: (209) 931-2186 Date: November 15, 2018 Facility Address: 4344 E Waterloo Rd, Stockton, CA 95215 CERS ID: 10181341 Inspection Contact: Theresa Rodriguez , Title: Assistant Manager Phone: 0 - Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 2361 - UST FACILITY Consent For: I=1 Inspection El Photos I=1 Samples Consent Given By: Theresa Rodriguez, Assistant Manager Service Technician Onsita Exp. Date: Jarrod Cooke 04/06/2019 Designated Operator: Exp. Date: Elijah Pendergraft 10/14/2019 Service Technician Manufacturer's Training VMI, 02/23/19; FFS, 05/07/20; Veeder-Root, 04/17/20 CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284 Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees DV DR DCOS 102 HSC 25284(a)(3)(A)/ (B) No written agreement between tank owner and tank operator to monitor the tank system oV oR DCOS 103 HSC 25292.2, 25299.30 Failure to submit and maintain complete and current financial responsibility documents oV DR ECOS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current DV DR oCOS 105 CCR 2632(d)(1), 2634(d) Failed to have an approved UST monitoring plan DV (DR oCOS 106 CCR 2632(d)(2), 2634(e) Failed to have an approved UST response plan DV DR oCOS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed EV DR ECOS 108 CCR 2637, 2638(e), 2643(g) Failed to notify the EHD 48 hours prior to conducting testing oV oR DCOS 109 CCR 2637(a-d), 2712 Failed to test secondary containment, or failed to maintain test records for 36 months EV oR ECOS 110 CCR 2637(e), 2637(f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test DV oR DCOS 111 CCR 2638(a) & (b), 2641(j) Failed to test monitoring and leak detection equipment annually oV DR oCOS 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance oV oR DCOS 113 CCR 2638(c), 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test DV oR oCOS 114 CCR 2636(f)(3), 2643(c)(3) No 0.1 gph annual line integrity test for pressurized piping, or within 30 days after repair oV oR oCOS 115 CCR 2715(a)(1)(B), 2715(a)(3) "Designated Underground Storage Tank Operator Identification Form" not submitted within 30 days oV oR oCOS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification DV DR DCOS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining, recordkeeping, and inspection requirements oV ER DCOS 118 CCR 2715(a)(1)(A), 2715(a)(2) Failure to submit the "Underground Storage Tank Statement of Understanding and Compliance Form" DV oR o COS 119 HSC 25299(a)(8), 25299(b)(7) Documents were falsified or misrepresented DV ER oCOS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification EV oR DCOS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report oV ER DCOS FA0003717 PR0231766 SC001 11/15/2018 EHD 23-01 Rev. 09/22/16 Page 1 of 4 Underground Storage Tank Program OIR