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• <br />SA6JOAQUIN <br />COUNTY_. _ <br />r 1 <br />LJ <br />Environmental Health Department <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address:Date: <br />PARKWOODS GAS & FOOD <br />1612 W HAMMER LN, STOCKTON <br />May 15, 2018 <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 />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 END'S CURRENT HOURLY RATE. <br />Received by: Date: May 15, 2018 <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />AARON HANG, REHS <br />(209) 468-3453 <br />6p--� Jesse Tiwana, Owner <br />FA0003611 PR0231127 SCO01 05/15/2018 <br />EHD 23-01 Rev. 10/31/2017 Page 4 of 4 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 />