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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, Califomia 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sogov.org/ehd <br />CONTINUATION FORM <br />Page: 4 of 4 <br />OFFICIAL INSPECTION REPORT <br />Date: 08/06/13 <br />Facility Address: 430 W Center Street, Manteca <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, or MINOR -Notice to Comply) <br />204. The designated operator failed to check and note the correct test dates for the monitoring system <br />certification and secondary containment testing on the following designated operator monthly inspection <br />reports: September 2012, October 2012, November 2012, and December 2012. Furthermore, the <br />November 2012 designated operator inspection report listed the inspection date as 11-0-2012_ During <br />the monthly inspection, the designated operator shall check that all required testing and maintenance for <br />the UST system have been completed and document the dates they were done. Ensure that designated <br />operators performing future monthly inspections at this facility are including all of the required <br />information on the reports. <br />Note: A copy of Owner Statement of Designated UST Operator form featuring updated ICC expiration <br />dates was provided to the EHD at the time of inspection. <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 />EHD Inspector: <br />Received By: <br />Title: <br />Elena Manzo (209) 953-76991--"44Z <br />EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />