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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.orq/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: T2057 <br /> cility Address: Date: <br /> QUICK STOP MART* S EL DORADO ST STOCKTON Aril 28 2015 <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 May 21, 2015. <br /> "*The monitoring system certification, spill container testing, and leak detector testing were completed today. See <br /> the inspection report issued on April 21, 2015 for previous violations cited. All EHD staff time associated with <br /> today's reinspection will be billed at the current hourly rate($130). <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 /> Provided: Return to Compliance Certification form <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received ByReceived By(printed name and title): Date: <br /> (signature): �(�, Krishna Gajjala, Realtor <br /> Inspector Inspector(printed name and title): '4spector Phone: <br /> (signatur STACY RIVERA, Senior REHS (209)468-3440 <br /> Page 4 of 4 <br />