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RECEIVEU JAN 15 2020 <br /> SAN J OAQ U I N Environmental Health Department <br /> COUNTY <br /> Greatness grows here , <br /> Corrective Action Statement <br /> RE : January 15 , 2020 , Underground Storage Tank inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was done to correct the violation in the space provided below each violation . Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please contact <br /> Shewit Woldearegay at (209) 468-0216 or stwoldearegay(@,sjgov. orq . <br /> Facility name CHEVRON STATION #210997 " Submit completed form to: <br /> Facility address : 1442 Colony Dr SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID. 10184539 ATTN , SHEWIT WOLDEAREGAY <br /> PR0518458 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #121 - Failure to implement corrections and submit written response within 30 days of receiving <br /> the report. <br /> EX This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> Describe actions taken or will betaken to correct violation <br /> It is not our intention to close Notice to <br /> Comply actions late . We were waiting on dOCUMUnt-abull . <br /> Page 2 of 2 <br /> Rev 827/2019 <br /> 1868 E Hazelton Avenue j Stockton , California 95205 1 T 209 468-3420 1 F 209 464 -0138 1 www slcehd com <br />