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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.siclov.orci/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> SRH FOOD & G^ 749 E DR MARTIN LUTHER KING JR BLVD, May 22, 2014 <br /> Environmental Reporting System (CERS): UST Monitoring Site Plan, UST Certification of Financial <br /> Responsibility, UST Response Plan, UST Owner/Operator: Written Agreement(if applicable), UST Letter from <br /> Chief Financial Officer, and Owner Statement of Designated UST Operator Compliance After January 1, 2015, <br /> noncompliance with this requirement will be a violation. <br /> Updated financial responsibility documents were provided at the time of inspection. <br /> Provided: Return to Compliance Certification form <br /> ALL=STAFF TIME ASSOCIATED-WITH FAILING TO GOMPFY BY THE ABOVE NO I L17DATES WILL 13E BILLLU A7 THE Cr1TRrR7TF59R=iE <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received By, Title: Date: <br /> V0 <br /> inspector: STACY RIVERA Title: Senior REHS Phone: 209 468-3440 Date: (15122/2014 <br /> Page 4 of 4 <br />