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San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California95205-6232 <br />Telephone: (209) 468-3424 Fax: (209) 468-3433 Web: www.5i92Y--0-r-q/—ehd <br />Underground Storage Tank Program Inspection Report <br />Rate: <br />Facility Address: .January 21. 2016 <br />�Facility Name: 442 Colony Dr, RIPON <br />EVRON STATION #!210997" <br />documents Into the California Environmentai Rep rt se KlaSysn IJSTELRette Letter ChiefrFinancial Officeriif <br />Certification of Financial Responsibility, UST Resp <br />applicable), and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator; Written <br />Agreement, if applicable.. can be stored at the facility or uploaded into CERS. <br />AFTER THE COMPLIANCE DATE, EHD WILLHIS FA CL <br />THIS F ITY IS SUBJECT TO REINSF Tinted name <br />Received By (p <br />Manager <br />FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />! BACK INTO COMPLIANCE <br />TION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br />(signature): <br />(signature): <br />(printed name ana uuCy. <br />MANZO, Senior RENS <br />®E <br />(209) 953-7699 <br />