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San Joaquin County lqw <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.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />PARKWOODS GAS & FOOD <br />1612 W HAMMER LN STOCKTON <br />MaV 07 2015 <br />* Assistant Manager filled out the recordable release statement for diesel found in UDC #4. <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 By <br />Received By (printed name and title): <br />Date: <br />(signature): <br />Juan Bataz, Assistant Manager <br />S --- <br />Inspector `.,�— <br />Inspector (printed name and title): <br />Inspector Phone: <br />(signature): <br />FATINAH ZAREEF, REHS <br />(209) 953-7311 <br />w Page 5 of 5 <br />