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SANJ 0 A Q U I Environmental Health Department <br /> CU17Y <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> WATERLOO FOODMART 4315 E WATERLOO RD STOCKTON Aril 30 2019 <br /> Other Violations <br /> 2010 1 See below Unlisted General violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> On site to witness testing of the 87 and 91 spill containers. Both passed. Verified 5 gallon capacity. This testing <br /> completes the annual monitoring inspection which was due by April 2019. <br /> Sensor functionality, VPH communication, and leak detector testing were conducted on March 25, 2019 under <br /> SR0078796; that testing will serve as the initial portion of the annual inspection, resetting the inspection due date <br /> to March 2020. <br /> The paperwork inspection is still needed and is being scheduled with the manager. A complete report will be <br /> provided at the time of paperwork inspection. <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 30, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: STACY RIVERA, Senior REHS (209)468-3440 <br /> Sagar Pradhan, Cashier <br /> FA0003831 PR0231760 SCO01 04/30/2019 <br /> EHD 23-01 Rev.09/28/2018 Page 4 Of 4 Underground Storage Tank Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />