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Environmental Health Department <br />CP22 - HMBP Inspection Report <br />Date: <br />July 01, 2024 <br /> Facility Address: <br /> 444 W MOSSDALE RD, LATHROP <br /> Facility Name: <br /> Mossdale Chevron <br />finished on 7/1/2024 and 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, within 30 days of receiving the complete inspection report, 7/31/2024. <br />Pal Dhaliwal, <br />Environmental Contact <br />July 01, 2024 <br />(209) 616-3029Printed Name and Title: <br /> Date: Inspector: <br /> Matthew Won, EHS <br /> Inspector Phone: Received by: <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br />FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />FA0000212 PR0520915 SC001 07/01/2024 <br />EHD Rev. 12/06/2021 CP22 - HMBP OIRPage 4 of 4 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD