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0 SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.or_q/ehd/unitiii.html <br />CONTINUATION FORM <br />Page: 4 of 4 <br />OFFICIAL INSPECTION REPORT <br />Date: 07/28/11 <br />Facility Address: 1612 W Hammer Lane <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS 11, or MINOR -Notice to comply) <br />Notes <br />1. Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br />each violation was corrected, including supporting documentation, by August 28, 2011. <br />2. The line leak detectors and sensor positive shutdown could not be tested today since the store is <br />under construction, fuel is not being dispensed, turbines could not be authorized and the tanks contain a <br />small amount of fuel. Schedule the line leak detector test and positive shutdown test when the station is <br />in a condition to test them, before opening the station for business. Notify the EHD. The annual <br />monitoring system certification is due by the end of July 2011. <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 FA ILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Ins ry- <br />Receiv <br />Title: pp <br />v V i v p �/ <br />EH 02- Rev 07/12/11 CONTINUATION FORM <br />