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SANJ O A Q U I N Environmental Health Department <br /> COUNJ Y <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CHEVRON STATION #94275" 2905 W BENJAMIN HOLT DR STOCKTON June 12 2019 <br /> Documents provided: Return to Compliance Certification form, schedule of free CUPA classes <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br /> FACILITY BACK INTO COMPLIANCE <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: Date: June 12, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: SHEWIT WOLDEAREGAY, EHS Trainee (209) 468-0216 <br /> Ruvian Laurel,Assistant Manager <br /> FA0003712 PR0231952 SCO01 06/12/2019 <br /> EHD 23-01 Rev.09/28/2018 Page 5 of 5 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 />