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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0232418
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
1/13/2023 9:12:31 AM
Creation date
3/23/2022 3:11:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0232418
PE
2361
FACILITY_ID
FA0004064
FACILITY_NAME
WATERLOO LIQUOR
STREET_NUMBER
2512
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14128102
CURRENT_STATUS
01
SITE_LOCATION
2512 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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2512 E Waterloo Rd, Stockton Record ID PR0232418 <br /> 3/30/2022 UST Inspection <br /> Photo 3: Designated operator failed to comply with designated operator requirements. Several reports were shrunken in size so 2 pages fit on <br /> one a e. <br /> -raf <br /> ,,rtomround Storage.-- ^r„nn Report <br /> Underground Storage Tank <br /> Appendix X111 pesignated UST operator Visual Inspection Report <br /> Underground Storage Tank c8on Report _ <br /> Designated UST Operator Visual lnspe Ilance issue rorn Section 3. <br /> 6. OWNERIOPERATOR DESCRIPTION OF FOLLOW @P apmPl <br /> .Pond 1. <br /> low <br /> on <br /> S,PACILIT t INFORMATION emceat duenext30 doactllOw up <br /> ga If not completed appropriate <br /> pp P <br /> Inspection Date 3.28.2022 r8 there sitar <br /> CERS Q overfill Inspection also should be completed then 3 y <br /> 1, <br /> C FacllriyNameWATERL00LIQUORS TIP Code <br /> City 95205 <br /> F FfldlltyAddrera Stockton <br /> 2612 a Waterloo rd <br /> 1 2.DESIGNATE DUSTOPERATO"FORMATION <br /> Phone <br /> Name of Designated UST Operator 569.688-2977 <br /> Dared Turner 9788460— Certification Expiration Dale <br /> ICC unification 9.7-2029 <br /> ].COMPLIANCE ISSUES <br /> rtlentlry by number eh'compflente Issues listed <br /> /r 8. OWNER OPERATOR ACKNOWLEDGEMENT OF INSPECTION RIESULTS <br /> I havo reviewed the results of the designated UST operator Inspection report and provided a <br /> / dascri tion of the actlon(s)taken or to betaken to correct any compliance Issues discovered. <br /> Name of UST Ow er 1 O orator(print) a � Z1G <br /> a M C ! � <br /> am m m S7 Owner/Opo for Signature Date Signed <br /> JJ L Via 4 4 �N p m xi m 9 <br /> 8 SC Im m N a s N INSPECTION HISTORY <br /> rvu° urvary L mrvvN <br /> E- m m « Has each follow-up action of Section 3 from the previous pet gnated UST Yes No NA <br /> e $ L e ° L ° <br /> �'S ' °, 0. c u v n Operator Inspection Report been completed appropriately? <br /> a ti (Attach documentation vert rn a ra trate service to this re ort, ® ❑ ❑ <br /> �aamum <br /> _ S. RELEASE DETECTION ALARM HISTORY <br /> T CERTIFICATION BY DEBIGNATED UST OPERATOR CONDPECTION <br /> Attach a copy of the aiar7n history reporUiog ro this repot} <br /> I hereby ceniry that the divisivisuaon <br /> Ina.chapter <br /> way perfamlad in compliance with Cellfdmis Code Yes No NA <br /> Is the monitoring system powered on and in proper operating mode? <br /> of Regulatlona,tette 21,division 3,chapter 18,section 2718 end all Information provided herein h acunt°, Has each alarm since the previous inspection been responded to appropriately? ® ❑ <br /> Del 111'd UST Operator Signal: Dele Inspection Rapon Provided;o Owner (Attach documentation vanfying appropriate service to this report.) <br /> devld <br /> tumor Have all containment sum s, ® ❑ ❑ <br /> 3.28.2022 designated UST operator ns taction report. <br /> an alarm since the previous <br /> CERS.Callftmla Envlronmamal Repomng System,ICC= P <br /> StoragIdentifle <br /> Tan NA•Not Applka6le,UDC=Undar•nlspenser Containment,UST 0uncil,ip= service technician? R rl,been responded to by a qualified <br /> Stange Tank ® ❑ ❑ <br /> Underground <br /> All answers marked°No”must be described by the designated(-1ST 0 <br /> Page 104 Aerator in Section 3. <br /> Page 2 of 4 <br /> John Alaniz, REHS Page 3 of 3 <br />
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