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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sagov.org/ehd <br /> CONTINUATION FORM Page: 5 of 5 <br /> OFFICIAL INSPECTION REPORT Date: 05/01/14 <br /> Facility Address: Pilot Flying J #617 15237 N. Thornton Rd. Lodi, CA, 95242 Program: HW <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS 11,or MINOR-Notice to Comply) <br /> 703. An emergency coordinator and modified contingency plan information is lacking. There must be <br /> at least one emergency coordinator on site or on call to coordinate emergency response measures, and <br /> the following information must be posted by a phone: the name and phone number of the emergency <br /> coordinator; location of fire extinguishers, spill control equipment, and if present, fire alarm; and the <br /> phone number of the fire department, unless the facility has a direct alarm. Immediately appoint an <br /> emergency coordinator and post the required information by a phone. A form is provided that can be <br /> used for this purpose. Submit proof of correction to the EHD by June 1, 2014. <br /> Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br /> each violation was corrected, including supporting documentation, by June 1, 2014. <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 EINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: _ - Title: <br /> Aris Veloso (209) 468-3453 "j 6AUI - -�— w <br /> EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />