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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.sagov.org/ehd <br />CONTINUATION FORM <br />Page: 5 of 5 <br />OFFICIAL INSPECTION REPORT <br />Date: 05/01/14 <br />Facility Address: Pilot Flying J #617 15237 N. Thornton Rd. Lodi, CA, 95242 <br />Program: HW <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS 11, or MINOR -Notice to Comply) <br />703. An emergency coordinator and modified contingency plan information is lacking. There must be <br />at least one emergency coordinator on site or on call to coordinate emergency response measures, and <br />the following information must be posted by a phone: the name and phone number of the emergency <br />coordinator; location of fire extinguishers, spill control equipment, and if present, fire alarm; and the <br />phone number of the fire department, unless the facility has a direct alarm. Immediately appoint an <br />emergency coordinator and post the required information by a phone. A form is provided that can be <br />used for this purpose. Submit proof of correction to the EHD by June 1, 2014. <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 June 1, 2014. <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 EINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />Received By: _ - <br />Title: <br />Aris Veloso (209) 468-3453 I <br />w <br />EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />