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.sj ocLv.org/ehd <br />'73 <br />t: <br />fund Storage 3 cRepo <br />rt', <br />Facility Name: Facility Address: Date: <br />COUNTRY CLUB FOOD & FUEL MINI MART* 1856 W COUNTRY CLUB BLVD STOCKTON June 09 2016 <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 />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: Inspector: Inspector Phone: <br />Printed Name and Title: FATINAH ZAREEF, RENS (209) 953-7311 <br />,k <br />Dine 7 -f 7 <br />