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SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: April 08, 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. <br /> Also, describe what was done to correct the violation in the space provided below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact Paul Nso at(209)468-3432 or pnso@sjgov.orq. <br /> Facility name: Colonial Energy CE 40138 (DBA Power Mart) Submit completed form to: <br /> Facility address: 14000 E HWY 88 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10169775 ATTN: PAUL NSO <br /> PR0231631 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Viollattiion#103-Failure to submit and maintain complete and current financial responsibility documents. <br /> ,tQ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑l Supporting documents included <br /> n <br /> Describe actions taken or will be taken to co ct violation: �LV n � Z <br /> l/i s I a <br /> [A ' <br /> �!9� c r o <br /> _ce <br /> ¢5 _ 112 0�2S l b o2.v <br /> Violation#105-Failed to have an approved UST monitoring plan. <br /> This violation was corrected ❑ This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Descrilia actions taken or will be taken to correct violation: <br /> I / /0/aW C) Ii t ct 6G/ R S <br /> Violation#113-Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test.. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> Supporting documents included <br /> Describe actions ken or vyill be i�lfen to correct violation: <br /> i n if G //LPC <br /> Page 2 of 4 <br /> Rev.82//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 />