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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUNT <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> KISHIDA, GEORGE INC 1725 ACKERMAN DR, LODI November 16, 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 /> OBSERVATION: Financial responsibility documents submitted in CERS is incomplete. Section B was not <br /> completed. <br /> REGULATION GUIDANCE: Current financial responsibility documents are required to be submitted annually. <br /> CORRECTIVE ACTION: This violation was corrected on site. <br /> This is a repeat violation, Class II. <br /> 202 CCR 2712(i) Failure to retain a paper or electronic copy of the permit to operate at the facility. <br /> OBSERVATION:A current copy of the UST operating permit was not found on site. The most recent permit on site <br /> was dated 2022. <br /> REGULATION GUIDANCE:A copy of the UST operating permit and all attachments and conditions shall be <br /> retained at the facility. <br /> CORRECTIVE ACTION: Immediately obtain a copy of the 2023 permit and retain it on site. <br /> This is a minor violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by November 16, 2023. <br /> Line testing was also conducted today. Only the start of the test was witnessed. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($162). To schedule an appointment, please call (209)468-3420. <br /> FA0003756 PR0231309 SCO01 11/16/2023 <br /> EHD 23-01 Rev.12/06/2021 Page 4 of 5 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 />