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Ak <br />Aek <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sqqov.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name:Facility Address: Date: <br />Tower Mart #10- 192 Lathrop Rd, Lathrop January 07, 2015 <br />8/2016. <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 Owner/Operator: Written Agreement (if <br />applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator <br />Compliance. <br />ALL EHD STAFF TIME ASSOCIATED W1 I H FAILING TO COMPLY BY I HE A8OVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RAT <br />THIS FACILITY IS SUBJECT TORE NSPECTION AT ANYTIME AT EHD'S CURRENT HOURLY RATE <br />Receiv <br />(signatu <br />)• <br />Title: <br />Date: <br />I I� <br />Received�Y (prints n <br />me): <br />Inspector: <br />Inspe for Pho e: <br />Y <br />MICHELLE HENRY, Senior RE <br />09) 468-3454 <br />Page 5 of 5 <br />