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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />4868 East Hazelton Avenue, Stockton, Caiiforlia 95205-6232 <br />Telephone. (209) 468-3420 Farr: (209) 468-3433 Web: www.§jao_j&WLqW <br />CONTINUATIONFORM <br />Page: 4 of 4 <br />OFFICIAL. IREPORT <br />Date: 07/013114 <br />Pro ram: UST <br />Facility Address: Quik Stop Market ##3148 205 W. Locketord St. Lodi, CA 95240 <br />SUMMARY OF VIOLATIONS <br />CLASS 1 CLASS 11 or MINOR-Notics to Comply) <br />999HSC 25404(e)(4) Electronic submittal requirement on the California Electronic Reporting System <br />(CERS) has not been met. The Owner Statement of Designated UST Operator ' Information has not been <br />entered or uploaded in CERS. Facility shall submit electroltic information for hazardous materials <br />management system, including Hazardous Waste and LIST on the CERS website which can to found at <br />http://cers.calepa.gov/. Facility operators are required to upload the following UST program documents <br />Into the California Environmental Reporting System (CERS)': UST Monitoring Site Plan, US`f <br />Certification of FinancialResponsibility, UST Response Flan, LISTOwner/Operator: VOitten Agreement <br />(if applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated LIST <br />Operator Compliance. Immediately comply with the CERS electronic submittal requirement per this <br />section. <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, by 8-8-14. <br />ALL END STAFF nME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO NSPE-n= RLY RATE. <br />END Inspector: <br />W-49 <br />Aris Veloso (0) 450-345 /(r <br />EHD 23-02-003 Rev Wlig/92 l "'jf CONTINUATION FORM <br />J <br />