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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.sigov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> TRACY76 1 2420 W GRANT LINE RD, TRACY May 22 2018 <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 provided: Return to Compliance Certification form, schedule of free CUPA classes <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br /> FACILITY BACK INTO COMPLIANCE- <br /> THIS <br /> OMPLIANCETHIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: Date: May 22, 2018 Inspector: Inspector Phone: <br /> Printed Name and Title: STACY RIVERA, Senior REHS (209) 468-3440 <br /> Celina Perez, Administrative Assistant <br /> FA0003963 PR0231580 SCO01 05/22/2018 <br /> EHD 23-01 Rev.09/22/16 Page 6 of 6 Underground Storage Tank Program OIR <br />