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San Joaquin County <br /> Environmental Health Department <br /> 1868 Eo,,Hazelton Avenue, Stockton, California 91---j-6232 <br /> Telephone: (209)468-3420 Fax: (209)468-3433 Web:www_smgov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> I-RUISERS MANTECA#29 1 1137 VV LATHROP RD MAN T Aril 21 2015 <br /> Overall Inspection Comments: <br /> Onsite to verify monitoring system functionality after the replacement of the Veeder Root vacuum sensor assembly <br /> and a monitoring system coldstart(SR0071527) conducted today. While onsite violations were noted, and as such <br /> this inspection report was issued. <br /> Submit a copy of the Return to Compliance Certification form to the EHD with a statement documenting the <br /> corrective actions that have been or will be taken for each noted violation, and any supporting paperwork. by May <br /> 21, 2015. <br /> Please be aware that as of January 1, 2014, facility operators are required to upload the following UST progran, <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 /> 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 /> Received By Received By(printed name and title): Date: <br /> (signature): LOuraeS Deiossantos, Manage: <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): ELENA MANZO, REHS ( <br />