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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.s'gov.org/ehd <br /> CONTINUATION FORM Page: 5 of 5 <br /> OFFICIAL INSPECTION REPORT Date: 05/14/13 <br /> Facility Address: 76 Express Market 419 South Main Street, Manteca Program: UST <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Submit to SJC EHD within 30 days (06/14/13): <br /> 1. one copy of the completed "Return to Compliance Certification" form <br /> 2. a written corrective action statement <br /> 3. requested/ supporting documentation ie. Owner Statement of Designated Operators <br /> Notes: <br /> -Photograph copy of the 2013 Certification of Financial Responsibility and Letter from Chief Financial <br /> Officer. <br /> - 91 and diesel spill bucket's swivel adapter were switched (diesel does not need swivel adapter). New <br /> O-ring and adapter was placed on the 87 spill bucket. 91 spill bucket drain valve repaired. <br /> - Spoke with operator Bobby explaining CERS data is incomplete. <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 END'S CURRENT HOURLY RATE. <br /> EHD Inspector Receied y: Title: <br /> �; �� <br /> EHD 2-003 Rev 9/12 CONTINUATION FORM <br />