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• SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd/unitiii html <br /> CONTINUATION FORM Page: 4 of 4 <br /> OFFICIAL INSPECTION REPORT Date: 06/22/10 <br /> Facility Address: USA Gas Station #68154 2500 W. Lodi Ave. Lodi, CA 95240Program: HW <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Com <br /> #52 The modified contingency plan was not available for review. Tania Wise, Assistant Manager <br /> completed the modified contingency plan form and posted it next to the cash register and phone. <br /> Complete and submit the return to compliance certification form, corrective action statements for each <br /> violation, and any supporting documentation to this office by 7-22-10. <br /> ALL END STAFF TOE ASSOCIAT®MRIH FAILING TO COMPLY BY THE ABOVE NOTED DATES MALL BE BILLED AT THE CURRENT HOURLY RATE j$1 15J <br /> THIS FACILITY IS SUBJECT TO REINSPECTI N AT ANY TIM AT END'S CURRENT HOURLY RATE. <br /> EHD Inspedor. _ R BY: Title: <br /> J/� J7� r <br /> EHD 23-02-003 Rev 06/01/10 CONTINUATION FORM <br />