Laserfiche WebLink
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 /> Costco Wholesale#658 3250 W GRANT LINE RD, Tracy September 25, 2014 <br /> supervisor. This facility's designated operator is Gabriel Martin, who was retained, according to the onsite <br /> records, on 8-28-2014 (ICC expiration date:6-5-2016), ensure that the Owner Statement of Designated UST <br /> Operator is updated in CERS by 9-28-2014. The service technician was Chad White(ICC expiration date: <br /> 6-20-16 ), who had the following manufacturer's certifications: VR-9-2-2016, VMI-4-3-2015. <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 Owner/Operator: Written Agreement(if <br /> applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator <br /> Compliance. Please be aware that the monitoring system certification test report must be submitted into CERS <br /> within 30 days of testing. <br /> ALLEHDSTAFF I IME A650UMI ED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED Al THE CURRENT HOURLY RATE <br /> THIS FACILITYAS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received By: I Title: Date: <br /> [ -C- OC'S 5E f o� + dC.V,\j I q- Zs- I <br /> Inspector: ELENA MAN ZO Title: REHS Phone: 209 953-7699 Date: 09/25/2014 <br /> Page 4 of 4 <br />