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San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax; (209) 468-3433 Web: www.sigj oy.orWehd <br />�ndi tcgroluhld: fiar; g Tank Arogra n InspeE#ion" pc rt <br />Far,ility Name: Facility Addrass: Qata. <br />CHEVRON STATION #307709' 10858 TRINITY PKWY STOCKTON Aril 15 2015 <br />Overall Inspection Corninents: <br />Complete and submit a copy of the Retum 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 mAY 15, 2015. <br />Please be aware that as of January 1, 2014, facility operators are required to upload the following UST program <br />documents into the California Environmental Reporting System (CERS): UST Monitoring Site Plan, UST <br />Certification of Financial Responsibility, UST Response Plan, UST Letter from Chief Financial Officer(if <br />applicable), and the Owner Statement of Designated Operator Compliance. The UST Cwner/Operator-, Written <br />Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br />NOTES: <br />Verified all sensors at lowest point <br />THIS FACILITY 13 SUBJECT TO REINSPECTION AT ANY TIME AT EHO'S CURRENT HOURLY RATE <br />Receivod By Received By (printed name and title): Dais: <br />(slgnature): Rosella Biggs, Manager <br />Inspector Inspector (printed name and tido): inspector Phone: <br />(signature):;. p p h FATINAH ZAREEF, REHS (209) 953-7311 <br />Page ". RECEIVEL <br />MAY 262015 <br />ENVIRONMENTAL: <br />UC A v TU r1C0A OTAACh1T <br />