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A NJ O A Q U l N Environmental Health Department <br /> COUNTY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> GRIN INVESTMENTS INC DBA:ARCO AM/PM 6009 N EL DORADO ST, STOCKTON November 08, 2023 <br /> Single-Walled Non-Pressurized Piping <br /> 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 <br /> Other Violations <br /> 2010 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 107 HSC 25292.2; CCR 2711(a)(11)Failure to submit and maintain complete and current financial responsibility <br /> documents. <br /> 1).OBSERVATION:The Certificate of financial responsibility document submitted to the EHD did not include the <br /> name of witness or notary. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION: Immediately log into the California Environmental Reporting System (CERS)at <br /> http://cers.calepa.ca.gov/, and upload the required documents. <br /> -------------------------------------------------------------------------------------------------------------------------------- <br /> 2). OBSERVATION: Current financial responsibility documents were not found on site. <br /> REGULATION GUIDANCE:A copy of current financial responsibility documents are required to be maintained on <br /> site. <br /> CORRECTIVE ACTION: Immediately obtain a copy of the facility's financial responsibility documents and maintain a <br /> copy on site. <br /> This is a minor violation. <br /> 115 CCR 2638(c), 2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> OBSERVATION:Annual monitoring system certification and leak detector testing was performed on 11/30/2022 and <br /> a test report was submitted on 02/10/2023, 71 days late. <br /> REGULATION GUIDANCE:A copy of the test report must be submitted within 30 days of the tests. <br /> CORRECTIVE ACTION: Take all necessary precautions to ensure testing and submittal of test reports are <br /> performed in a timely manner. <br /> This is a minor violation. <br /> FA0024188 PR0542116 SCO01 11/08/2023 <br /> EHD 23-01 Rev.12/06/2021 Page 4 of 7 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />