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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0544259
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COMPLIANCE INFO_2022
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Last modified
8/2/2022 9:43:41 AM
Creation date
1/6/2022 9:07:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0544259
PE
2361
FACILITY_ID
FA0024739
FACILITY_NAME
TOKAY SHELL
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN # 1
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Tokay Shell —420 W Kettleman Ln, Lodi, CA 95240 Record ID PR0544259 <br /> 1/7/2022 <br /> PHOTO# 13 <br /> IMG E1224, Violation#208 <br /> Desi nated o erator re ort 4/30/2021 does not address alarms that occurred 4/21/2021. <br /> L y.g7�BTk' <br /> fiTF' FJNIP � RM' <br /> F«NL�yLHR CMIGI o _ <br /> Urwerground Storage Ta <br /> Designated UST Operator visual in on Report <br /> 1. FACILITY INFORMATION Inspectio r Date 413 <br /> Celxs ID <br /> Facility Name Tokay Sheri city ZIP Code Facility Address Lodi 95242 <br /> 420 W.Kettiman Lane <br /> 2. pESIGNATED UST OPERATOR INFORMATION <br /> Phone <br /> Name of Designated UST Operator 925-389-1282 <br /> Alex Jabbari <br /> Certification Expiration Date <br /> ICC certification 91=2 <br /> 5243897-UC <br /> 3. COMPLIANCE ISSUES <br /> Waste oil tank monthly visual inspection <br /> No follow up needed at this time <br /> I <br /> I <br /> 4. CERTIFICATION BY DESIGNATED UST OPERATOR CONDUCTING INSPECTION <br /> I hereby certify that the visual inspection was performed in compliance with California Code <br /> of Regulations,title 23,division 3,chapter 16,section 2716 and all information provided <br /> herein is accurate. <br /> Designated UST Operator Signature Date Inspection Report Provided to Owner <br /> CERS=California Environmental Reporting System, ICC=International Code Council,ID= <br /> Identification, NA=Not Applicable,UDC=Under-Dispenser Containment,UST=Underground i< <br /> Storage Tank <br /> UN411 www_unidocs.org Rev.9101no Rage 1 ofQ <br /> Carol Presto, EHS Page 13 of 16 <br />
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