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San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />ehd <br />Telephone. (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: Facility Address: Date: <br />California Fuel Supply 2575 Country Club Blvd, Stockton January 14, 2015 <br />facility's designated operator is Paul Dew (ICC expiration date: 3-18-15) . The service technician was Felix <br />Ramirez (ICC expiration date: 11-26-16), who had the following manufacturer's certifications: VR 7-7-16, VMI <br />11-12-15. <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. <br />ALL EHD STAFF TIM ASSOCIATED WITH FAILING TO COMPLY BY I HE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br />Received B (signature): Title: Date: <br />/ILI <br />Received By (p� name): <br />Inspector. <br />Inspector one: <br />tJi— Ro& <br />FATINAH ZAREEF, REHS� <br />(209) 953-7311 <br />Page 4 of 4 <br />