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+ San Joaquin County 0 <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjoov.orq/ehd <br /> 7CIPORN; <br /> Underground Storage Tank Program Compliance Review Report <br /> Facility Name: Facility Phone: Date: <br /> RALEYS FUEL STATION A356 (916) 373-3333 March 11, 2017 <br /> Facility Address: CERS ID: <br /> 4219 E MORADA LN, STOCKTON, CA 95212 10185183 <br /> Inspection Contact: Title: Phone: <br /> Mike Gabbert Environmental Contact <br /> VIOLATIONS <br /> The following non-inspection related violations listed below from the California Health and Safety Code (HSC), California <br /> Code of Regulations (CCR) and/or the Code of Federal Regulations (CFR)were found. <br /> #103 HSC 25292.2 Current financial responsibility documents not submitted <br /> OBSERVATIONS:The Certificate of Financial Responsibility document uploaded to CERS is greater than 365 days old. <br /> The insurance document is up-to-date. The Certificate of Financial Responsibility document is required to be submitted <br /> annually. Immediately log into the California Environmental Reporting System (CERS)at http://cers.calepa.ca.gov/, and <br /> upload the required document. Print, sign and date the form with the tank owner representative and a witness. <br /> This is a minor violation. <br /> OVERALL NOTES AND COMMENTS <br /> The EHD cannot issue the 2017 UST operating permit until the above violation is resolved. <br /> 9179 9690 0935 0118 0998 01 <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE <br /> THIS FACI SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Inspector /� Inspector(printed name and title): Inspector Phone: <br /> (signature)'.,_ GARRETT BACKUS, Lead Senior REHS (209)468-2986 <br /> FA0016523 PR0624617 SCO21 03/11/2017 <br /> Rev.01/08/16 Page 1 of 1 Underground Storage Tank Program Compliance Review Report <br />