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Ask <br />San Joaquin County IV <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sicgov.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />IJanUary.,-'' <br />Date: <br />)rnia Fuel Supply <br />: rJ'. Ry Stockton <br />kation of Financiai ibility. _ eu �'ian, U� i getter from Chief Financial Officer if <br />appiicable), and the OwnF s D�Latement of L)esignatt u �-,,perator Compliance. The UST Owner/Ooerator: Writte: <br />Agreement; if applicable; can be stored at the facility or uploaded into CERS. <br />Notes: <br />- Verified all sensors at lowest Point <br />- The facility is not operating to the public <br />� TER THE COMPLIANCE DATE. EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />HIS FACILITY BACK INTO COMPLIANCE. <br />THIS LITY JEV TO REINSPECTION AT ANY TIME AT END'S CURRENT HOURLY RATE <br />Received By <br />Received By (printed name and title): <br />Date: <br />(signature): <br />Dave Hinds <br />Inspector J _ - <br />Inspector (printed name and title): <br />Ins or hone: <br />(signature): <` <br />''09) 953-7311 <br />Page 4 or 4 <br />