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0 SAN JOAQUIN COUNTY 0 <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 />CONTINUATION FORM <br />Page: 4 of 4 <br />OFFICIAL INSPECTION REPORT <br />Date: 04/01/13 <br />Facility Address: 2057 S. EI Dorado St., Stockton <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, or MINOR -Notice to Comply) <br />205. The June 2012 designated operator monthly inspection report was not found on site. Designated <br />operator monthly inspection reports for the previous twelve months shall be retained on site. Locate and <br />ensure that copies of the previous twelve months of designated operator monthly inspection reports are <br />maintained on site. Submit copies to the EHD by May 1, 2013. <br />Complete and submit a copy of the Return to Compliance Certification to the EHD by May 1, 2013 along <br />with a statement documenting the corrective actions that have been or will be taken for each violation <br />and any supporting paperwork. <br />Note: The designated operator for this site has been changed from Karen Arnaiz to Dave Winkler, et al. <br />(Affordatest) as of March 29, 2013. An updated Statement of Designated Operator was observed on <br />site, but not submitted. According to Mr. Winkler, a copy will be faxed to EHD. Any changes in <br />designated operator shall be reported to the EHD with 30 days of the change. <br />Provided: <br />- Schedule of FREE classes <br />- Financial Responsibility forms <br />- CERS Lead User Authorization form <br />- Return to Compliance Certification form <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 ATA Y TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />By: <br />Title: <br />Stacy Rivera (209) 468-3440 <br />[Received <br />01 6yo 1AL <br />I <br />EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />