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San Joaquin County <br />Environmental Health Departments -' <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.or /q ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />SUPER CENTER MART* <br />701 E DR MARTIN LUTHER KING JR BLVD, <br />June 20, 2016 <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, within 30 days of receiving the complete inspection report. <br />Note: The annular sensor was tested and alarmed. It then went in and out of both fuel alarm and sensor out alarr <br />for approximately 30 minutes. At the completion of the inspection the annular sensor was no longer in alarm. ThE <br />technician could not find a reason for the repeated alarms. <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 />Documents reviewed: CERS submittals, Designated operator (DO) monthly inspection reports, DO training log, <br />maintenance records, alarm history <br />Documents provided: Return to Compliance Certification form <br />SEP 09 <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br />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 />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />STACY RIVERA, Senior REHS <br />(209) 468-3440 <br />Page 4 of 4 <br />