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SAN J O A Q U I N Environmental Health Department <br /> CC)U ,IN I Y <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> KWIK SERV LODI BW 113* 420 W KETTLEMAN LN, LODI January 18, 2022 <br /> paperwork, by 02/17/2022. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: Inspection report, corrective action statement form and a schedule of <br /> free CUPA training classes. <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: January 18, 2022 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EH Specialist (209)616-3049 <br /> E mailed report to:Monica Farhat, Environmental Contact <br /> FA0003776 PR0231906 SCO01 01/18/2022 <br /> EHD 23-01 Rev.12/06/2021 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 />