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S A N J O A Q U I N Environmental Health Department <br /> C:C3U N I Y <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> JACK IN THE BOX#3427 1081 S MAIN ST, MANTECA February 19, 2021 <br /> Fahmy, performed an on-site inspection for the CO2 tank on 12/03/2021. <br /> There were 3 violations during the in-office inspection. Complete and submit a copy of the Return to Compliance <br /> Certification form to the EHD with a statement documenting the corrective actions that have been or will be <br /> taken for each violation, and any supporting paperwork, by 3/19/2021. <br /> Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate ($152). To schedule an <br /> appointment, please call (209)468-3420. <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: February 19, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: KRISTINA SAETERN, EHS Trainee (209)616-3045 <br /> Email to Pardeep Singh, District Manager <br /> FA0006729 PR0520663 SCO01 02/19/2021 <br /> EHD 19-01 Rev.9/16/2020 Page 3 of 3 Hazardous Materials 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 />