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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 /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> QUICK STOP MART' 2057 S EL DORADO ST, STOCKTON Aril 21 2015 <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 May 21, 2015. <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials information <br /> online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be sure to include <br /> your hazardous waste activity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> *`This facility's 2015 permit fees have not yet been paid and are overdue. A penalty will be applied if they are not <br /> paid by April 27, 2015, resulting in double fees. <br /> Provided: Return to Compliance Certification form, Application for an EPA ID number <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE <br /> THIS FACILITY I UBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received By Received By(printed name and title): Date: <br /> (signature): `' �V, Billa Dhillon, Owner's son - Site supervisor ZI <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature. ., STACY RIVERA, Senior REHS (209) 468-3440 <br /> Page 6 of 6 <br />