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COMPLIANCE INFO_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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2300 - Underground Storage Tank Program
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PR0231021
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COMPLIANCE INFO_2022
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Last modified
12/28/2022 4:49:35 PM
Creation date
1/27/2022 8:11:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231021
PE
2361
FACILITY_ID
FA0003625
FACILITY_NAME
ARCO STATION #83560*
STREET_NUMBER
2908
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09763032
CURRENT_STATUS
01
SITE_LOCATION
2908 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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SAN�D | [l 8 [lh U | N ����������������� ��ealt' <br /> ��� |� ]��U W � |� _ <br /> ! <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be corrected within 30 days of <br /> receipt ofthis inspection. This certification form must be submitted to the Environmental Health Department(EHD)address at <br /> the bottom nfthis form within 3Udays nfreceipt ofthe Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form,or disputes to any <br /> vio|adnna, are to be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the <br /> Inspection Report. HSC 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be billed <br /> mtthe current hourly rate. <br /> For this certification to be complete, the operator of the site must include: <br /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying corrections <br /> Operator's certification <br /> Uns^ mot|on Dote: January 26, 2022 Inspected By: LYDIA BAKER <br /> Facility Address: 2S08VVBENJAMIN HOLT DR, 'TOCKT(}N CERS |D: 10181253 <br />
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