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Am <br />Ak <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />aSHIDA,E i:. <br />° <br />nFber20, 2015 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS 11, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days. <br />A new designated operator was hired on 0-5-15 and notification was not provided to the EHD within 30 days of the <br />change. Any changes shall be reported to the EHD within 30 days. During the inspection, Kelli Kishida uploaded the <br />updated notification identifying David Rouse as a designated operator for this facility. Continue to log into the California <br />Environmental Reporting System (CERS) at http://cers.calepa.ca.gov as needed to upload the notification identifying <br />all the designated operators for this facility. Corrected on site. <br />This is a repeat violation. Class ll. <br />Overall Inspection Comments: <br />�)i =duct a routine inspection and vii ness the annual monitoring system certification testing. <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, UST <br />Certification of Financial Responsibility, UST Response Pian, UST Letter from Chief Financial Officer (if <br />e); and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator: Written <br />WL; ; ;nt, 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 BILLEDAT THE CURRENT HOURLY RATE. <br />THIS FACILITY TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received By <br />Received By (printed name and title): <br />Date: <br />(signature): <br />Kelli Kishida, Secretary <br />t t /?'v ((�j <br />Inspector <br />Inspector (printed name and title): <br />Inspector Phone: <br />(signature): <br />REHS <br />f2� <br />Page 4 of 4 <br />