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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 /> Q U I K STOP MARKET#2152 1 1721 S CHEROKEE LN LODI June 22, 2015 <br /> On site to conduct a routine hazardous waste inspection. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 7-22-15. <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 /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE <br /> IS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD-S CURRENT HOURLY RATE <br /> Received Bi/ Received By(printed name and title): Date: (l' / <br /> (signature): Raja Muneeb Urrehman, Employee <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): ARTS VELOSO, Senior REHS (209) 468-3453 <br /> Page 5 of 5 <br />