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SAN <br /> J D �� I Environmental Health Department <br /> COUNTY— <br /> Underground <br /> OU T — <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Colonial Energy CE 40135(DBA Power Mart) 192 Lathrop Rd, Lathrop January 03, 2018 <br /> financial responsibility, letter from chief financial officer, operating permit, monitoring plans, response plan. <br /> Documents received: return to compliance certification form <br /> Please be aware that as of January 1, 2014, facility operators are required to upload the following UST program <br /> documents into the California Environmental Reporting System (CERS): UST Monitoring Site Plan, UST <br /> Certification of Financial Responsibility, UST Response Plan, UST Letter from Chief Financial Officer(if <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 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: Date: January 03, 2018 Inspector: Inspector Phone: <br /> Printed Name and Title: BETTY HO, EH Specialist (209)468-3455 <br /> David White, Manager <br /> FA0007059 PR0505867 SCO01 01/03/2018 <br /> EHD 23-01 Rev.10/31/2017 Page 6 of 6 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />