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N J OA U Environmental Health C0Ui\iTY Corrective Acti ® n Saiaternent RE : January 29 , 2020 , Underground Storage Tank inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date . Also, describe what was done to correct the violation in the space provided below each violation . Submit this completed form with the Return to Compliance Certification within 30 days of inspection . If you have any questions, please contact Shewit Woldearegay at (209 ) 4681,,0216 or stwoldearegay@sigov. orq . Facility name : YOSEMITE PETROLEUM Submit completed form to : Facility address : 2072 W YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT CERS ID: 10181669 ATTN : SHEWIT WOLDEAREGAY PR0231426 1868 E HAZELTON AVENUE STOCKTON , CA 95205 Violation #101 - Failed to obtain a permit to operate from the END including but not limited to unpaid permit fees . ❑ This violation was corrected ❑ This violation will be corrected by (date) : ❑ Supporting documents included Describe actions taken or will be taken to correct violation : cam \ oil Violation #111 - Failed to test monitoring and leak detection equipment every 12 months. ❑ This violation was corrected ® This violation will be corrected by (date) : ❑ Supporting documents included Describe actions taken or will be taken to correct violation : C ,A L _�•=�-�-- c1 � n. . � � ti...z.�.-� -fie o, =��ce `ane �-� Violation #123 - Failure to submit the "Spill Container Testing Report Form" within 30 days after the test. ❑ This violation was corrected ❑ This violation will be corrected by (date) : ❑ Supporting documents included Describe actions taken or will be taken to correct violation : Rev. 8/27/2019 Page 2 of 3 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468-3420 1 F 209 464 -0138 1 w�nAv. sjeehd .com