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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.siaov.org/ehd <br />CONTINUATION FORM <br />Page: 5 of 5 <br />OFFICIAL INSPECTION REPORT <br />Date: 01/21/14 <br />Facility Address: 6425 Pacific Ave., Stockton <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, or MINOR -Notice to Comply) <br />Note: (continued) <br />7. Description of corrective and remedial actions <br />8. Methods of clean up implemented to date, and proposed clean up actions with a time <br />schedule <br />9. Method and location of disposal of waste generated from release and clean up. Attach copies <br />of any hazardous waste manifests. <br />10. Description of proposed methods of repair or replacement of primary or secondary <br />containment <br />11. Description of additional actions taken to prevent future releases. <br />Ensure that complete reporting is made within the required time frame. <br />Provided: Return to Compliance Certification form <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 IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />Received By: <br />Tittle: <br />Stacy Rivera (209) 468-3440 <br />EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />