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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.onq/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> 1�), I -I'A, 'A MF-3,1 HANIAN PI) I IN[ A I <br /> R �'�l C S 0 IL f-R F V"�i C, I I' <br /> SUMMARY OF VIOLATIONS <br /> (CLASS 1,CLASS 11,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 210 CCR 2715(e) Designated operator monthly inspection reports not maintained on site for at least 12 months. <br /> The Octobef 2C!,,.; No er*," _'01 t; . February 2017 March 2017 a - <br /> '�)16 11111-1,11y 2017 vi�l Ap!0 21" <br /> 17 <br /> tof Inoothiv Inspection It, <br /> des-'Jnated ope;'-I 'pol-tswele not f0tilld on site DesigiiatedopeiatorfTloiitl)lyinspectiot <br /> -I <br /> epo,tsfor the site Locate and ensure that copies of the preViOL"S <br /> twelve months of desgmtod Opel ator monthly Inspection reports are maintained on site Submit copies to the <br /> Overall Inspection Comments: <br /> Conloiete and submit a copy of the Return to Compliance Certification form to the EHD with a stateT?ent <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> papen,vork by November 24, 2017 <br /> Please be aware that as of January 1 2014 facility operators are required to upload the following UST program <br /> documents into the California Environmental Reporting System (CERS) UST Monitoring Site Plan LIST <br /> Certification of Financial Responsibility. UST Response Plan, LIST Letter from Chief Financial Officer (!,, <br /> applicable) and the Owner Statement of Designated Operator Compliance The LIST OwneriCiperator Wratten <br /> Agreement. if applicable. can be stored at the facility or uploaded into CERS <br /> Reviewed monitoring plans site map DO reports, tank information, facility information and alarm history <br /> A <br /> Received by: onto: October 25 2017 Inspector: Inspector Phone: <br /> Printed Name and Title: <br /> JOHN ALANI", Spec"11'st 2 <br /> Joy Kachadoiian Fli'Smana(el <br /> I FA0006898 PROS05615 SC001 10r215(2017 <br /> Page 5 of 5 Underground Storage TankPrngrw�,)IR <br /> EHD 23-01 Rev.09122/16 <br />