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>♦ <br />Urage v o� g <br />IWF <br />lqw San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California95205-6232 <br />Telephone. (209) 468-3420 Fax: (209) 468-3433 Web. vwvw.si4ov.ora/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />KA!`=RMANENTE <br />373 WE .N. `N <br />JanuG <br />of Financia _ p _ �onse Plan, US l" Letter from Chief Financial Officerl.ir <br />af- -�. r�ie;, <br />and the Owner Stateme.wL u, Designated Operator Compliance. The UST Owner/Operator: Writt-,,i <br />Act; :lament; <br />if applicable, can be stored at the facility or uploaded into CERS. <br />NOTES. <br />- On site for <br />routine inspection. MSC was done on 7-7-15 <br />AFTER THE CORL NCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />THIS FACILITY BACK INTO COMPLIANCE <br />THi <br />ILI iS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br />ReceivedBy <br />Received By (printed name and title): <br />eryIG2(.fEngineer <br />Date: <br />(signature): <br />Inspector <br />Inspector (printed name and title): <br />Inspector Phone: <br />(signature): <br />j,S <br />%09) 953-7311 <br />Urage v o� g <br />