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S A J O A Q U I N Environmental Health Department <br /> COUNTY - AMENDED <br /> 3/18/2021 <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> SAFEWAY FUEL CENTER#1769 2802 COUNTRY CLUB BLVD, STOCKTON March 16, 2021 <br /> An inspection report was provided to the facility operator on March 16, 2021. The report was amended and <br /> replaces the initial report. <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, within 30 days of receiving the amended inspection report. <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 EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: March 16, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: VICKY VANG-LEE, EH Specialist (209)616-3028 <br /> Emailed to Sandra Harbaugh, Manager <br /> FA0012764 PR0516736 SCO01 03/16/2021 <br /> EHD 23-01 Rev.9/16/2020 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.sjgov.org/EHD <br />