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S A J OAQ U I Environmental Health Department <br /> �. 0U N TY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CHEVRON STATION 499840* 4344 E Waterloo Rd, Stockton November 04, 2020 <br /> of having them sign. <br /> Documents provided: Return to compliance ceritification form, Corrective action statement form and a list of <br /> approve CUPA free training classy <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: Date: December 02, 2020 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EH Specialist (209) 616-3049 <br /> E Mailed to Kim Castillo, Manager <br /> FA0003717 PR0231766 SCO01 11/04/2020 <br /> EHD 23-01 Rev.9/16/2020 Page 5 of 5 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />