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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 /> FOOD MART GASOLINE- 2185 E FREMONT ST, STOCKTON September 28 2015 <br /> paperwork, by October 28, 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 /> Wastes generated at this facility: <br /> - Fuel contaminated water <br /> -Absorbent <br /> - Fuel filters <br /> Provided: Return to Compliance Certification form, Schedule of free CUPA classes, Application for an EPA ID <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 ANYTIME AT EHD'S CURREN HOURLY RATE <br /> Received By Received By(printed name and title): �� Date: <br /> (signature): Vinay Verma, Manager <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature STACY RIVERA, Senior REHS (209) 468-3440 <br /> Page 7 of 7 <br />