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�.ncvrwiv [G 1 zu:f_1OL-J1/y P. <br /> Agency Inspection Report Fax <br /> (Please fax in ALL Agencl r Inspection Reports with or without corrective actions) <br /> DAI E: 0 1 1 13 Pages: <br /> APR 2 2��4 (Including cover) <br /> TC : Permit Desk <br /> FAX (925) 842-9585 0 (925) 842-5660 <br /> RECEIVED <br /> F M; Station # 307709/2218 Stockton CA <br /> (Chevy n Facility #) I (CSI #) MAY 01 2014 <br /> TAL <br /> Phone Number: 209-952-221ENVIRONMENDEPgRTTAHEALTH <br /> Pr rt Manager Name: Ros lla Biggs <br /> My acility received the attached (check appropriately below): <br /> ❑ NOV-Notice of Violation: A C ocument issued by a Government or Local Agency identifying a <br /> violadon or condition that requires a corr ctive action by a specified date and may require payment of a <br /> monelary fine or penalty. <br /> ❑ TC - Notice to Comply: A do iument issued by a Government or Local Agency identifying a <br /> viol at on or condition of non-compliance that requires a corrective action by a specific date but does not levy a <br /> moiketary fine or penalty. <br /> ❑ C 1ther: 100% or Any Government or Local Agency document or communication(these include a <br /> suc e sfully passed inspection) <br /> I have also notified my BC SL RESH representative via phone and/or fax. <br /> NE r ie of BC: Diane Province <br /> N e of RESH Specialist: Gerardo Acuna <br /> N t s: REPORT TO BE SE NT LATER BY INSPECTOR RAN OUT OF <br /> TIM E <br /> Indo <br /> cl <br /> to faxing in the (legible) inspection report, please place a copy of the notice <br /> int the Retail Facility Compliance Workbook under Section 9 "RFC Inspections". <br /> Updated 7-18-2011 <br />