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S A N aJ O A Q O) N Environmental Health Department <br /> —COUNTY <br /> �rxUndectSto�ag ro�i�t �tron R � � <br /> N n�,�.' . <br /> -��'� ,. <br /> Facility Name: Facility Address: Date: <br /> QUIK STOP MARKET#3138 1153 LINCOLN BLVD, TRACY August 07,2018 <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 September 6th, 2018. <br /> Document reviewed: Monitoring system certification test results 2015, 2016, 2017, secondary containment test <br /> results 2016, employee training, response plan,financial responsibility documents, maintenance records, <br /> monitoring plan and designated operator monthly inspection reports from August 2017-July 2018. <br /> Documents provided: Return to compliance certification. <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 /> 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: August 07, 2018 Inspector: Inspector Phone: <br /> Printed Name and Title: ZUNA BARKER, EH Specialist (209)953-7311 <br /> Aman Litt, General Manager <br /> FA0003122 PR0231413 SCO01 08/07/2018 <br /> EHD 23-01 Rev.10/31/2017 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 />