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San Joaquin County 40 <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sigoy.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> JIFFY LUBE#598 1130 N MAIN ST, MANTECA Au ust 05. 2015 <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 9/4/2015 S . <br /> Please be aware as of Januaryl, 2013, all businesses are required to submit all hazardous materials information <br /> online to the California Environmental Reporting System(CERS) at http://cers.calepa.ca.gov. Be sure to include <br /> your hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING OMPL HE ABOVE NOTED OTTES WILL BE BILLEDA T . <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received ByReceived By(printed name and title): Date: <br /> v, i <br /> (signature): rip, �-- Na Her, Manager fj`5--/'�— <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): NICHOLAS LOEHRER, HM Specialist 1 (209) 468-0623 <br /> Page 2 of 2 <br />