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S A N J O A Q U I N Environmental Health Department <br /> C:C3U N I Y <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> BlackHawk Petroleum Inc. 5611 E WATERLOO RD, STOCKTON July 07, 2021 <br /> Documents provided during inspection: inspection report, return to compliance certification, corrective action <br /> statement, blank certification of financial responsibility, blank letter of chief financial officer, and list of free <br /> 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: July 07, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: VICKY VANG-LEE, EH Specialist (209)616-3028 <br /> Emailed to Lupna Hussain, Owner <br /> FA0002160 PR0231764 SCO01 07/07/2021 <br /> EHD 23-01 Rev.9/16/2020 Page 6 of 6 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.sjgov.org/EHD <br />