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S A N J 0 A Q I I I Irl Environmental Health Department CCUN r Underground Storage Tank Program Inspection Report Facility Name: Facility Address: Date: BlackHawk Petroleum Inc. 5611 E WATERLOO RD, STOCKTON July 19, 2022 Single-Walled Non-Pressurized Piping 404 CCR 2643(e),2661(f) Failure to conduct 0.1 gph test on single-walled gravity piping biennially or post repair(pre-1984) ❑V ❑R ❑COS Other Violations 2010 See below Unlisted General violation ❑V ❑R ❑COS SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 107 HSC 25292.2; CCR 2711(a)(11)Failure to submit and maintain complete and current financial responsibility documents. OBSERVATION: Current financial responsibility documents have not been submitted to the EHD. The Certification of Financial Responsibility and the Letter from the Chief Financial Officer had the dates whited out and rewritten- new signatures and asset/liability amounts were not obtained. The asset and liability amounts on the Letter from the Chief Financial Officer have not been updated since prior to 2014. REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at http://cers.calepa.ca.gov/, and upload the required documents. OBSERVATION: Current financial responsibility documents were not found on site. REGULATION GUIDANCE:A copy of current financial responsibility documents are required to be maintained on site. CORRECTIVE ACTION: Immediately obtain a copy of the facility's financial responsibility documents and maintain a copy on site. This is a repeat violation, Class 11. 115 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test. OBSERVATION:Annual monitoring system certification, leak detector testing, and spill container testing was performed on 7/7/21 and a test report was submitted on 11/15/21, 101 days late. REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are performed in a timely manner. This is a repeat violation, Class 11. FA0002160 PR0231764 SCO01 07/19/2022 EHD 23-01 Rev.12/06/2021 Page 4 of 7 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD