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SAN JOAQI II N Environmental Health Department <br /> C:OU NTY I� <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> QUIK STOP MARKET#551121 1 1196 W LOUISE AVE, MANTECA May 19, 2021 <br /> Overall Inspection Comments: <br /> An inspection checklist was provided to the facility operator at the time of inspection. The EHD has written the <br /> complete report on 05/24/2021 which replaces the initial checklist. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 06/23/2021 . <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: Inspection report check list. <br /> Waste streams found: Contaminated liquids. <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: May 24, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: PAUL NSO, EH Specialist (209)616-3049 <br /> E mailed to:MHilfinger@cumberlandfa, Environmental Contac <br /> FA0000848 PR0506233 SCO01 05/19/2021 <br /> EHD 22-01 Rev.9/16/2020 Page 5 of 5 Small Quantity Hazardous Waste Generator 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 />