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S A J OAQ U I Environmental Health Department <br /> �. 0U N TY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> PACIFIC AVE CHEVRON 6633 PACIFIC AVE, STOCKTON January 21, 2020 <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by February 20, 2020 . <br /> Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate($152). To schedule an <br /> appointment, please call (209) 468-3420. <br /> Documents provided during inspection: Return to compliance certification form, corrective action Statement and <br /> list of scheduled free CUPA classes <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS 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: January 21, 2020 Inspector: Inspector Phone: <br /> 6y*- <br /> Printed Name and Title: PAUL NSO, EHS Trainee (209)468-3432 <br /> Tom Upton, Director of Retail Operations <br /> FA0003834 PR0231784 SCO01 01/21/2020 <br /> EHD 23-01 Rev.9/20/2019 Page 6 of 6 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />