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SAN J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Arco. Am pm 83333 550 W Valpico Rd, Tracy October 25, 2017 <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 /> Documents reviewed: Tank and monitoring plan, CERS submittals, financial documents, monitoring certification <br /> test report, employee training log, DO monthly report, alarm logs, and maintenance records. <br /> Documents received: Return to compliance certification form <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: October 25, 2017 Inspector: Inspector Phone: <br /> Printed Name and Title: BETTY HO, EH Specialist (209)468-3455 <br /> Edgar Rizkallah, Owner <br /> FA0020989 PR0536555 SCO01 10/25/2017 <br /> EHD 23-01 Rev.09/22/16 Page 6 of 6 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />