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• <br />• <br />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 />CONTINUATION FORM <br />Page: 4 of 4 <br />OFFICIAL INSPECTION REPORT <br />Date: 07/08/14 <br />Facility Address: Quik Stop Market #3148 205 W. Lockeford St. Lodi, CA 95240 <br />Program: UST <br />SUMMARY OF VIOLATIONS <br />CLASS 1, CLASS II, or MINOR -Notice to Comply) <br />999. HSC 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 electronic information for hazardous materials <br />management system, including Hazardous Waste and UST on the CERS website which can be 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, UST <br />Certification of Financial Responsibility, UST Response Plan, UST Owner/Operator: Written Agreement <br />(if applicable), UST Letter from Chief Financial Officer, and Owner Statement of Designated UST <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 EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TOR INSPEC ON AT ANY TkME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />ed By: <br />Title: <br />Aris Veloso (209) 468-345 49 <br />k.� -2�� <br />EHD 23-02-003 Rev 04/19/12 I �j CONTINUATION FORM <br />