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S � Environmental Health Department <br /> COU N7 <br /> —&Wr f• <br /> r. Greotness grows here. <br /> Inspection Report <br /> Facility Name: Date: <br /> KISHIDA GEORGE INC October 03 2025 <br /> Facility Address: Facility Phone: Program Record: <br /> 1725 ACKERMAN DR, LODI, CA 95240 (209)368-0603 PR0231309 <br /> Inspection Contact: Title: Phone: <br /> Jeremy Cummins Service Technician ()- <br /> Inspection Type: Program: <br /> Field Activity/Other Inspection 2361 - UST FACILITY <br /> OUT=Violation R=Repeat violation COS=Corrected on site during inspection <br /> 0 <br /> Overall Inspection Comments <br /> COMMENTS <br /> Met onsite with technician Jeremy Cummins,who stated he was present to remove and replace the diesel penetration boot <br /> and to scrape off the incorrect sealant (`Sikaflex')and reseal it with `IBond.' I informed him that a permit would be required prior <br /> to conducting the work. The facility owner provided a copy of the Permit Application; however, I explained that the application <br /> had never been filed with EHD. The supervisor of Mr. Cummins confirmed that while the application had been prepared, it was <br /> not submitted because they believed a permit was not necessary. <br /> No repair work was initiated by technician Jeremy Cummins. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: October 03, 2025 Inspector: Inspector Phone: <br /> Printed Name and Title: Monica De Anda, EHS (209)616-3063 <br /> Jeremy Cummins, Service <br /> Technician <br /> FA0003756 PR0231309 SC2160 10/03/2025 <br /> EHD Rev.04/07/2022 Page 1 of 1 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 />