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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.oM/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name- Facility Address: Date- <br /> J 8 11 r, 3 UNCOI.N-BLVD. A��uus� 27, 2015 <br /> -oreld at d,,ie lladflty Of U I -i I <br /> P�io,',.a d e d, i r"i t, R S, <br /> A,grei:mr-ient. it -�,ppiicable, car"i be, st, . <br /> LLEHSTAFF 7IME-ASS—MIATED WITH FAILING TO COMPLY BY THE AB5MMU�A—TESWILLB 81CLED Af THE CURRENT HOURLY RAT <br /> E. <br /> THIS.FAG PT,Y IS§UBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received By Received By(printed name and title): Date, <br /> (signature)- Sa ,n A i �k sa, G e,n e�a� V1,-k�1 a,�,,,e ;�/15 <br /> Inspector Inspector(printed name and title): Ins ector Phone: <br /> `11: INA MANZ'0 Senior REI-iS (209) 953-7699 <br /> (signature): -1- L.- <br /> Page 5 of 5 <br />