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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.si4ov.orq1ehd <br />CONTINUATION FORM <br />Page: 4 of 4 <br />OFFICIAL INSPECTION REPORT <br />Date: 05/05/14 <br />Facility Address: 7611 S Airport Way, Stockton, CA <br />Program:. UST <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, or MINOR -Notice to Comply) <br />Provided: <br />- Schedule of FREE classes <br />- Return to Compliance Certification form <br />Note: Facility operators are required to upload the following UST program documents into the <br />California Environmental Deporting System (CERS): UST Monitoring Site Plan, UST Certification of <br />Financial Responsibility, UST Response Plan, UST Owner/Operator: Written Agreement (if applicable), <br />UST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator <br />Compliance. After January 1, 2015, noncompliance with this requirement will be a violation. <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO CO LY BY THE AB VE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSF ECTION A IME AT EHD'S CURRENT HOURLY RATE. <br />EMD Inspector: Received <br />Title: <br />Elena Manzo (209) 953-7699 , I A ,A— fllt� — <br />- <br />EHD 23-02-003 Rev 04/19/12 � 1 <br />1 <br />� CONTINUATION FORM <br />