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MW San Joaquin County `W <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 />Facility Name: <br />QUIK STOP MARKET #3144 <br />Facility Address: <br />7272 WEST LN. STOCKTON <br />Date: <br />July 27 <br />Complete and submit a copy of the Return to Compliance Certification form to the Environmental Health <br />Department (EHD) with a statement documenting the corrective actions that have been or will be taken for each <br />violation, and any supporting paperwork, by August 26, 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 />Note: Secondary containment testing was last completed on September 17, 2013 and must be completed every <br />thirty-six months thereafter. The next secondary containment testing is due in September 2016. <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: <br />Date: July 27, 2016 1 Inspector: <br />Inspector Phone: <br />. Printed Name and Title: VICKI MCCARTNEY, Senior REHS (209) 468-9852 <br />Gurwinder Singh, Clerk <br />Page 6 of 6 <br />