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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.siaov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Safeway Fuel Center#1769 1 , Stockton a80& � �'i January 20, 2015 <br /> ALL EHD S[AFF I IME ASbOUIAI ED WITH FAILING TO COMPLY BY I HEABOVE NO I=U DATES WILL BE BILLED AT THE CURRENT HOURLY RAI E <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received By(signature): Title: Date: <br /> AAaAgd ------- � <br /> Recei ed By(printed name): Inspector: Inspector Phone: <br /> STACY RIVERA, Senior RENS 209)468-3440 <br /> Page 5 of 5 <br />