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San Joaquin County �t <br /> Environmental Health Department „ <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)468-3433 Web:www,sjgov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> 7-ELEVEN INC #17334 4501 N PERSHING AVE, Stockton October 03, 2017 <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: <br /> October 03, 2017 Inspector: Inspector Phone: <br /> Printed Name and Title: CESAR RUVALCABA, EHS Trainee (209) 953-6213 <br /> Hanesh Chauhan, Franchisee <br /> FA0002479 PR0231233 SCO01 10/03/2017 <br /> EHD 23-01 Rev.09/22/16 Page 5 of 5 Underground Storage Tank Program OIR <br />