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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 /> Underground Storage Tank Program Inspection Report <br /> Facility Name: ]-Facility Address: Date: <br /> LODI FOOD & LIQUORS 1225 W LOCKEFORD ST LODI November 18 2015 <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 /> ReceivedBy Received By(printed name and title): Date: <br /> (signature):I Zulfiqar Khan, Manager <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): ARIS VELOSO, Senior REHS (209)468-3453 <br /> Page 7 of 7 <br />