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..� 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.siaov.ora/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />I Facility Address: <br />Date: <br />PERSHING GAS <br />4445 N PERSHING AVE STOCKTON <br />March 04 2015 <br />Overall Inspection Comments: <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, by April 4, 2015 . <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 />ALL EHD STAFF TIME ASSOCIATED WITH FAILINGCOMPLY Y THE ABOVENOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RA . <br />THIS F IT IS S14BJJCTTO REINSPECTION AT ANYTIME AT EHD'S CURRENT HOURLY RATE <br />Received ByReceived <br />By (printed name and title(: <br />Date: 1 1 <br />(signature(: <br />Sukhivinder Cheema, Owner <br />Inspector <br />Inspector (printed name and title(: <br />InspeCtor Phone: <br />(signaturej: <br />FATINAH ZAREEF, REHS <br />(209) 953-7311 <br />v Page 4 of 4 <br />