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SANJOAQUI Environmental Health Department <br /> COUNTY <br /> t�c, v Greatness grows here. <br /> Corrective Action Statement <br /> RE: May 28, 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 WoldearegaV at(209)468-0216 or stwoldearegaV6c�sjgov.orq. <br /> MORADA CHEVRON FAST N EASY#60-, 10878 N HWY 99, CERS ID: 10180717, PR0231598 <br /> Violation#107-Plot plan/site map not submitted or failed to completely show where monitoring is <br /> performed. <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#111 -Failed to test monitoring and leak detection equipment every 12 months. <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#118-Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Page 3 of 6 <br /> Rev.8/27/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />