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A N J OAQ U I N Environmental Health Department <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> 1909 CEMETERY LN, Stockton September 11, 2025 <br /> Overall Inspection Comments <br /> Routine UST Inspection <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 paperwork, <br /> by October 11, 2025. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead of <br /> having them sign. <br /> Starting July 1, 2025, all in-office CERS help will be provided at EHD hourly rate ($179). <br /> To schedule an appointment, please call (209) 468-3420. <br /> Notes: <br /> - Ensure that the facility address on the DO monthly inspection report forms accurately reflect the location of the UST <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: September 11, 2025 Inspector: Inspector Phone: <br /> Printed Name and Title: Aaron Madera, EHS (209)616-3065 <br /> Michael Thomas, Environmental <br /> Contact <br /> EHD-CUPA Inspection Report IS02 Page 7 of 7 FA0004458 PR0231036 4549655 9/11/2025 <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 />