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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 /> R- <br /> d Storage_Tank. Report <br /> Facility Name: Facility Address: Date: <br /> COS MUNICIPAL SERVICE CTR 1465 S LINCOLN ST STOCKTON Aril 21 2016 <br /> paperwork, by May 21, 2016. <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: Designated operator(DO) monthly inspection reports, DO training records, maintenance <br /> records, test results, CERS submittals, alarm history <br /> Documents provided: Return to Compliance Certification form <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: April 21, 2016 Inspector: Inspector Phone: <br /> Printed Name and Title: STACY RIVERA, Senior REHS (209)468-3440 <br /> DougSmith Fleet Manager <br /> 9 <br /> Page 4 of 4 <br />