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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.sjgov.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />1701 <br />Date: <br />SUPER CENTER MART` <br />E DR MARTIN LUTHER KING JR BLVD, <br />June 19, 2014 <br />Consent to perform the insp?ction, take photos and collect samples was given by Swaran Chouhan, owner. This <br />facility's designated operator is Alex Jabbari (ICC expiration date: 10/6/14) . The service technician was Dave <br />Winkler (ICC expiration date: 3/3/16), who had the following manufacturer's certifications: Veeder-root (expiration <br />date: 2/10/16), VMI Tester (expiration date: 11/10/15). <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. After January 1, 2015, noncompliance with this requirement will be a violation. <br />Financial Responsibility documents were provided at the time of inspection (dated 6/15/14). <br />Provided: Return to Compliance Certification form <br />ALLEHDSIAFI­ rIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DAI - ES WILL BE BILLED AT THE CURRENT HOURLY RATE <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br />Received By: <br />Title: <br />Date: <br />Ins ector: STACY IV A <br />Title: Senior REHS Phone: (209), <br />Date: 06/19/2014 <br />Page 5 of 5 <br />