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San Joaquin Count • <br />�g�.goG `7 Y <br />Environmental Health Department <br />yY. 1868 East Hazelton Avenue, Stockton, CA95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />FILE COPY <br />'9cfFa�� <br />Underground Storage Tank Program Compliance Review Report <br />Facility Name: <br />Facility Phone: <br />Date: <br />PARKWOODS GAS & FOOD <br />(209) 951-9707 <br />April 07, 2016 <br />Facility Address: <br />CERS ID: <br />1612 W HAMMER LN, STOCKTON, CA 95209 <br />10181241 <br />Inspection Contact: <br />Title: <br />Phone: <br />The following non -inspection related violations listed below from the California Health and Safety Code (HSC), California <br />Code of Regulations (CCR) and/or the Code of Federal Regulations (CFR) were found. <br />OBSERVATIONS: The EHD received a notification per Afforda Test, that the UST Designated Operator service for the <br />facility has been canceled and will go into effect at the end of February 2016. Notification of a new Designated Operator was <br />not provided to the EHD by the facility within 30 days of the change. Any changes shall be reported to the EHD within 30 <br />days. <br />Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov and upload the <br />notification identifying all the designated operators for this facility. <br />Submit the Return to Compliance document (included with this report) along with a copy of your Designated Operator <br />inspection report for the month of March 2016 to this office by May 12, 2016. <br />This is a Class II violation. <br />u <br />These Non -Inspection Related Violations are being issued because: <br />1- You failed to make the following CERS submittal- Notification of a new Designated Operator was not provided to the EHD <br />by the facility within 30 days of the change. <br />9171 9690 0935 0087 3054 77 <br />LWf�°fjr1VG9T�,/�~lYa�i t1a'IEi�Pllitc3�®' o�d�fdT�, op?wo, ®s i"�TlG3L�7E1tt�1�ana2�CoT_�J ibU <br />hTl` � - C � 'Tr f, ' [Inspector <br />(signature): M11'r u <br />Inspector (printed name and title): Inspector Phone: <br />��FATINAH ZAREEF,0. 953-7311 <br />FAUUUM11 YKU1:3111/ J1:U11 U4/U//LUlb <br />Rev. 01/08/16 Page 1 of 1 Underground Storage Tank Program Compliance Review Report <br />