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Aft Alk AME DED <br /> qW <br /> 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.sjaov.org/ehd <br /> nderground Storage Tank Program Inspection'.k <br /> Facility Name: Facility Address: Date: <br /> PLAZA LIQUOR#1 800 S CHEROKEE LN LODI I March 28 2016 <br /> Complete and submit a copy of the Return 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, within 30 days of receiving the amended inspection report. <br /> Complete and submit a copy of the Return 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 5-4-16. <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 Owner/Operator: Written <br /> Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br /> Note: The current business owner began operating 11-16-15. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br /> FACILITY BACK INTO COMPLIANCE <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: Date: I^ Inspector: Inspector Phone: <br /> vt)— 6L) ' 2a V <br /> Printed Name and Title: ARIS VELOSO, Senior REHS (209)468-3453 <br /> /L/'// Page 6 of 5 <br />