Laserfiche WebLink
San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s1q0v-0rC_j/ehd <br />Underground Storage Tank Program Inspection Report <br />Date: <br />Facility pjartie: I Facility Address: 16v 18. 2015 <br />TRACY76 421. Grant Line Rd. i lac <br />documents into the California Environmental Reporting System(CERS): UST Monitoring Site Plan, UST <br />Certification of Financial Responsibility, <br />IST Response <br />Operator ST Le ncero The USTtter fm Chief IOwner/Opnancial ferator: iceKif <br />Written <br />applicable), and the Owner StatementDesignated <br />.Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING I v UUMILr o i i i �� - • • • __ _. - <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLYDate:RAT <br />Received By Received By (printed name and title):I <br />(� n <br />(signature): hC flA%"`�1 J l� ✓�"��j v P'RAra.: <br />����Inspeprinted name and title): Inspector Phone: <br />Inspector ANZO. REHS X53-7699 <br />(signature): <br />Page 5 of 5 <br />