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Environmental Health Department <br />Underground Storage Tank Program Inspection Report <br />Date: <br />January 26, 2023 <br /> Facility Address: <br /> 420 W KETTLEMAN LN, LODI <br /> Facility Name: <br /> KWIK SERV LODI BW 113* <br />Other Violations <br /> 2010 □ V □ R □ COSUnlisted General violation See below <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />RemarksItem # <br />Overall Inspection Comments: <br />An inspection checklist was provided to the facility operator at the time of inspection. The inspector will provide <br />a complete report to the facility operator within the next few weeks. <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 complete 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: Inspector Phone: <br /> KRISTINA SAETERN, EH Specialist <br /> Inspector:January 26, 2023 Date: <br />Printed Name and Title: <br />Emailed to Jas Bains, Owner <br />(209) 616-3045 <br />FA0003776 PR0231906 SC001 01/26/2023 <br />EHD 23-01 Rev. 12/06/2021 Underground Storage Tank Program OIRPage 4 of 4 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD