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0 SAN JOAQUIN COUNTY 0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sioov.org/ehd/unitiii.htmi <br />CONTINUATION FORM <br />Page: 4 of 4 <br />OFFICIAL N PECTION REPORT <br />Date: 07/13/11 <br />Facility Address: 2510 Jackson Avenue, Escalon <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />(CLASS 1, CLASS II, or MINOR -Notice to Comply) <br />Notes <br />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, within 30 days of receiving this report. <br />Facility's financial responsibility is due by 2/1/11 <br />Provided free CUPA class information. <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE ($115). <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />Received B <br />Title: <br />EHD 23-02-003 Rev 06/01/10 CONTINUATION FORM <br />