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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 /> CONTINUATION FORM Page: 4 of 4 <br /> OFFICIAL INSPECTION REPORT Date: 06/24/13 <br /> Facility Address: 1301 W. Kettleman Ln., Lodi, CA Program: UST <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Minor- Notice to Comply Violation: (104): <br /> 104. An updated copy of the Certification of Financial Responsibility, dated (in advance) July 7, 2013 <br /> was submitted to EHD at the time of inspection, however an updated copy of the Letter from Chief <br /> Financial Officer is still lacking. The most current Letter from Chief Financial Officer on file with the EHD <br /> is dated July 7, 2011. Current financial responsibility documents are required to be submitted annually. <br /> Complete and submit a copy of the most current Letter from Chief Financial Officer by July 24, 2013. <br /> Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br /> each violation was corrected, including supporting documentation, by July 24, 2013. <br /> 1j©tes `. SCLrV-q)Le C�p P. (eco f- <br /> a Lo -L � <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> If <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIMEAy.r CURRENT HOURLY RATE. <br /> EHD Inspector. Received By: Title: <br /> Jr <br /> AfF I <br /> EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />