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SAN JOAQUIN <br />C: C_3 lJ N I Y <br />Environmental Health Department <br />AMENDED <br />4/8/2024 <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />SAFEWAY FUEL CENTER #1769 <br />2802 COUNTRY CLUB BLVD, STOCKTON <br />April 04, 2024 <br />Other Violations <br />2010 <br />See below <br />Unlisted General violation <br />❑ V ❑ R ❑ COS <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />Overall Inspection Comments: <br />An inspection report was provided to the facility operator on the day of inspection. The report was amended and <br />replaces the initial report. Violations #117 and #122 was rescinded with the email response from Keith Power. <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, within 30 days of receiving the amended inspection report. <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: April 08, 2024 <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />KRISTINA SAETERN, EH Specialist <br />(209) 616-3045 <br />Emailed to Keith Power, Environmental Contact <br />FA0012764 PR0516736 SCO01 04/04/2024 <br />EHD 23-01 Rev. 12/06/2021 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.sjgov.org/EHD <br />