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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.sjgov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Unified Grocers, Inc. 1990 Piccoli Rd, STOCKTON November 18, 2014 <br /> Consent to perform the inspection, take photos and collect samples was given by Kim Powers, Fleet Shop <br /> Manager. This facility's designated operator is Ron Schmidt([CC expiration date: 7/11/2015) and Michael Young <br /> (ICC expiration date: 5/30/2015).The service technician was Victor Guerrero(ICC expiration date: 6/11/2015), <br /> who had the following manufacturer's certifications: VMI 9/23/2015, VR 7/31/2015. <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 Owner/Operator: Written Agreement(if <br /> applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated UST Operator <br /> Compliance. <br /> ALL EHD STAFF T E ASSOCIATED WITH FAILINGL ILL BE BILLED 77 THE CURRENT HOURLY <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Rec 'v By(signature): Title: Date: <br /> Received By(printed name): Inspector: �•-f� L(� Inspector Phone: <br /> Y 7 <br /> cy erS JEFFREY WONG, Senior REHS (209)468-0335 <br /> Page 4 of 4 <br />