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San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />derground Storage Tank Pry. pection Report <br />Facility Name: <br />Facility Address: <br />7Aug <br />Date: <br />H&M - BW #98 <br />2501 JACKSON AVE, ESCALON <br />ust 30, 2017 <br />Note: The monitoring plans for all three tanks list the site's designated operator, Karen Arnaiz, as the second <br />person have responsibility for the monitoring system. This role is typically filled by a facility employee or operator <br />and is not among the regulatory description of the duties of a designated operator. Provide documentation <br />supporting the listing of Karen Arnaiz as being responsible for the site's tank monitoring. If this documentation <br />cannot be provided, immediately update the monitoring plans to include current, accurate information. <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 Plan, UST Letter from Chief Financial Officer(if <br />applicable), and the Owner Statement of Designated Operator Compliance. The UST Owner/Operator: Written <br />Agreement, if applicable, can be stored at the facility or uploaded into CERS. <br />Documents reviewed: CERS submittals, alarm history, designated operator training records, designated operator <br />monthly inspection reports, work orders, daily alarm logs <br />Documents provided: Return to Compliance Certification form, Schedule of free CUPA classes, SJCEHD UST <br />Repair Permit Guidance <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br />FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br />Received by: Date: August 30, 2017 <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />STACY RIVERA, Senior REHS <br />(209) 468-3440 <br />Hamgi Elgahin, <br />Page 8 of 8 <br />