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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.sjgov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> MARIGOLD SHEL! 16131 PACIFIC AVE, STOCKTON August 19, 2016 <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: A copy of the Certificate of Liability Insurance was provided during the inspection today. <br /> Note: Verified all sensors at lowest point. <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: August 19, 2016 Inspector: Inspector Phone: <br /> Printed Name and Title: VICKI MCCARTNEY, Senior REHS (209)468-9852 <br /> Thanh Nguyen, Cashier <br /> Page 5 of 5 <br />