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Received 11/18/2022 SAN 10 AQU I N Environmental Health Department —COUNTY Greocriess —C4UNTYGreotness grows here. Underground Storage Tank Program Inspection Report Faclllty Name: Facility Phone: Date: A&A GAS FOOD MART (209)825-0332 November 18,2022 Facility Address: CERS ID: 1330 E YOSEMITE AVE,MANTECA,CA 95336 10184191 Inspection Contact: Title: Phone: Ghulam Ali Operator (510)396-5560 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 2361 -UST FACILITY Consent For: Consent Given By: FxJ Inspection ❑x Photos ❑Samples Roshal Dhillon,Cashier Service Technician Onsite: Exp.Date: Designated Operator: Exp,Date: Edward Stearns 11/05/2024 David Winkler 02/17/2024 Service Technician Manufacturer's Training: VR,07/31/23;VMI,05/27/23;FF,11/28/24 CCR=Title 23 California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations EHD=Environmental Health Department V=Violation R=Repeat violation COS=Corrected on site during inspection File Review }y, 101 HSC 25284;CCR Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ❑V ❑R ❑COS 2711(d) ri 102 CCR 2711 Failure to submit a complete and accurate application for a permit to operate a UST ❑V ❑R 13 COS •Ir V 103 CCR 2635(f),2636(c)(2) Failure to submit the UST Certification of Installation/Modification o V o R o COS 0 104 CCR 2632(d)(1),2634(d) Failure to submit a complete and accurate UST Monitoring Plan ■V ■R o COS 105 CCR 2632(d)(2),2634(e) Failure to submit a complete and accurate UST Response Plan o V ❑R o COS 106 CCR 2632(d),2641(h) Failure to submit and maintain a current facility plot plan/site map c V o R o COS 107 HSC 25292.2;CCR Failure to submit and maintain complete and current financial responsibility documents ■V ■R o COS ` , i• 2711(a)(11) 108 CCR 2620(b);HSC Failure to implement or maintain a written agreement between the UST owner and operator o V o R ❑COS 25284(a)(3) 109 1 CCR 2715(.)(1)(6), Failure to submit"Designated Underground Storage Tank Operator Identification Form"within 30 days ■V ■R ❑COS 2715(a)(3) 110 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" o V o R o COS 2715(a)(2) 111 CCR 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing o V o R o COS 2643(g) 112 CCR 2638,26410), Failure to have properly qualified service technician test leak detection equipment every 12 months o V o R o COS 2715(f) \ 113 CCR 2637(.-1),2712(b) Failure to conduct secondary containment testing o V o R o COS (1)(F) 114 CCR 2636(f)(3),2643(c) Failure to perform line integrity test every 12 months or within 30 days of repair of primary pipe o V o R o COS 115 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test u V o R o COS 116 JCCR 2637.1(d), Failure to submit the"Spill Container Testing Report Form"within 30 days o V o R o COS 2637.1(e) s 117 CCR 2637(.),2637(Q Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test o V o R c COS o 118 CCR 2637.2(d&e), Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within 30 days ■V ■R o COS 2665(.&b) 119 CCR 2663, 2712(b)(6) Failure to comply with tank lining certification,testing,inspection,and record requirements o V o R o COS 120 CCR 2631,2640.1, Failure to submit and/or maintain documentation regarding compatibility for UST system components o V c R o COS 2665,2711 FA0012355 PRO515864 Sc001 11/18/2022 EHD 23-01 Rev.12/06/2021 Page 1 of 7 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue Stockton, California 95205 i T 209 468-3420 1 F 209 464-0138 i www.Sjg0v.org/EHD �I