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S A J OAQ U I Environmental Health Department <br /> �. 0U N TY— <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> WEST LANE CHEVRON 4747 WEST LN, STOCKTON September 27, 2019 <br /> Documents provided: Return to Compliance Certification form, Corrective action statements form and a <br /> schedule of free CUPA classes <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: Date: September 27, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EHS Trainee (209)468-3432 <br /> Raj Kumar, Cashier <br /> FA0003719 PR0232482 SCO01 09/27/2019 <br /> EHD 23-01 Rev.9/20/2019 Page 5 of 5 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 />