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SAN J 0 A Q U I N Environmental Health Department -- COUN ( Y Great ►► vsi grows Iters . �" . Underground Storage Tank Program Inspection Report Facility Name : Facility Phone : Date: 7-ELEVEN STORE #41216 ( 800 ) 828-0711 June 01 , 2022 Facility Address : CERS ID : 770 W CHARTER WAY, STOCKTON , CA 95206 10876678 Inspection Contact: Title : Phone: Laura Powell Team Leader ( 209) 414-9204 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2351 - UST FACILITY - 2481 COMPLIANT Consent For: 17i3'nsenn By: ❑x Inspection ❑x Photos ❑ Samples Joel Hickok, Area Manager Service Technician Onsite: Exp. Date: Designated Operator: Exp , Date: Jesus Saldivar 06/11 /2023 Ramon Rios 06/03/2023 Service Technician Manufacturer's Training : VR, 04/21 /23 ; OPW, 11 /23/22 ; VMI , 11 /08/23 CCR = Title 23 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; CCR Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ■ V ❑ R ❑ COS 2711 (d) 102 CCR 2711 Failure to submit a complete and accurate application for a permit to operate a UST o V o R o COS 103 CCR 2635(f) , 2636(c) (2) Failure to submit the UST Certification of Installation/Modification o V o R o COS 104 CCR 2632(d) (1 ), Failure to have an approved UST Monitoring Plan o V o R o COS 2634(d) 105 CCR 2632(d) (2) , Failure to have an approved UST Response Plan o V o R o COS 2634(e) 106 CCR 2632(d), 2641 (h) Failure to submit and maintain a current facility plot plan / site map o V o R ❑ COS 107 HSC 25292.2; CCR Failure to submit and maintain complete and current financial responsibility documents o V o R o COS 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 o COS 25284(a)(3) 109 CCR 2715(a) (1 )(B) , Failure to submit "Designated Underground Storage Tank Operator Identification Form" within 30 days o V o R o 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 26381 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(a-d) , 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 (3) 115 CCR 2638(c) , 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test o V o R o COS 116 CCR 2637. 1 (d) , Failure to submit the "Spill Container Testing Report Form" within 30 days o V o R o COS 2637A (a) 117 CCR 2637(e) , 2637(f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test o V o R o COS 118 CCR 2637.2(d&e) , Failure to submit the "Overfill Prevention Equipment Inspection Report Form" within 30 days o V o R o COS 2665(a&b) 119 CCR 2663 , 2712(b) (6) Failure to comply with tank lining certification, testing , and inspection requirements o V o R o COS 120 CCR 2631 , 2640. 13 Failure to submit and/or maintain documentation regarding compatibility for UST system components o V o R o COS 2665, 2711 FAD026052 PR0546068 SC001 06/01 /2022 EHD 23-01 Rev. 9/16/2020 Page 1 of 6 Underground Storage Tank Program OIR 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjgov. org/EHD