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COMPLIANCE INFO_2018
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PR0541416
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COMPLIANCE INFO_2018
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Entry Properties
Last modified
7/22/2020 2:59:52 PM
Creation date
7/22/2020 2:57:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018
RECORD_ID
PR0541416
PE
2351
FACILITY_ID
FA0023733
FACILITY_NAME
Sunwest Chevron
STREET_NUMBER
2758
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
Ln
City
Lodi
Zip
95242
APN
16646031
CURRENT_STATUS
01
SITE_LOCATION
2758 W Kettleman Ln
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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2018-11-20 13:11 Sunwest Chevron 2758 >> 2094683433 P 1 <br /> San Joaquin County <br /> Environmental Health Department NOV 2 0 2018 <br /> 1868 East Hazelton Avenue, Stockton,California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov_orglehd �„�,��r,l^ ; <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply'in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EMD)address <br /> the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form,or disputes to any <br /> violations, are to be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the <br /> Inspection Report, HSC 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate. <br /> For this certification to be complete, the operator of the site must include- <br /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample resultslmanifests/training records/other appropriate paperwork, and/or photos vcrifying corrections <br /> Inspection Date: October 17, 2018 inspected By: STACY RIVERA <br /> Facility Address: 2758 W Kettleman Ln, Lodi CERS ID: 10748068 <br /> certify under penalty of law that: <br /> 1. I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> I believe the information to be true, accurate,and complete: <br /> Photos_Paperwork Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information,including the possibility of a fine and/ <br /> imprisonment for known violations. (HSC 25191) qavo(_ 11 Name: _1� v (� Title: �,� <br /> Signature: Date: l ( '21) 1'Z Q t$ <br />
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