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A dOAQU1N Environmental Health Department <br /> CQUNT AMENDED <br /> 1/27/2025 <br /> CP22 - UST FULL Inspection Report <br /> Facility Name: Facility Address: Date: <br /> KWIK SERV LODI BW 113' 420 W KETTLEMAN LN LODI January 24 2025 <br /> finished on January 27, 2025 and replaces the initial checklist. <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, February 26, 2025. <br /> NOTE: The financial responsibility documents in CERS will be expiring January 29,2025. Please ensure to upload <br /> current financial responsibility documents prior to January 29,2025 expiration date <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br /> 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 24, 2025 Inspector: Inspector Phone: <br /> Printed Name and Title: Carol Presto, Senior REHS (209)616-3061 <br /> Emailed to Monica Farhat, <br /> Operations&Compliance <br /> Coodinator <br /> FA0003776 PR0231906 SCO01 01/24/2025 <br /> EHD Rev.12/06/2021 Page 8 of 8 CP22-UST FULL 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 />