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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.orq/ehd/unitiii.htmi <br /> CONTINUATION FORM Page: 3 of <br /> OFFICIAL INSPECTION REPORT Date: 01/21/11 <br /> Facility Address: Sheriffs Operation Ctr/ SJC Motorpool 7000 Michael Canlis Blvd Program: UST <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS 11,or MINOR-Notice to Comply) <br /> UST Inspection: Routine and Annual Monitoring System Certification testing <br /> 4. Financial responsibility documents for the 2011 year have not been submitted to the EHD. Last <br /> financial responsibility document received on 01/28/2010 was only the Letter from Chief Financial <br /> Officer. Current financial responsibility documents, the Certification of Financial Responsibility (CFR) <br /> and Letter from Chief Financial Officer (CFO), are regUired to be submitted annually. Complete and <br /> submit a copy of the financial responsibility by 02/21/2012 . Repeat violation. <br /> Submit to SJC EHD within 30 days (02/21/2012): <br /> 1. one copy of the "Return to Compliance Certification" form <br /> 2. a written statement how to ensure future fir iancial responsibility documents are submitted in a timely <br /> manner. <br /> 3. copy of the financial responsibility documents: CFR and Letter from CFO <br /> Notes: <br /> - next tri-annual secondary containment testing due 08/2012 <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE($122). <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD In ector: Received P Title: <br /> x <br /> CONTINUATION FORM <br /> EHD 23-02-003 Rev 08/10/10 <br /> J <br />