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SAN JOAQUIN Environmental Health Department <br /> FOJ NTY <br /> Corrective Action Statement <br /> RE : July 10 , 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. org . <br /> Facility name : QUIK STOP MARKET #3144 Submit completed form to: <br /> Facility address : 7272 WEST LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10180967 ATTN: PAUL NSO <br /> PR0231939 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #103 - Failure to submit and maintain complete and current financial responsibility documents . <br /> Cf 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 /> The Financial Responsibility documents have been included in the new compliance binders and will be <br /> onsite next week. <br /> Violation #121 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> LN 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 /> For future inspections a written response documenting corrective actions taken or proposed will be <br /> submitted and all corrections implemented within 30 days of receiving report. <br /> Violation #201 - Failure to maintain monitoring , maintenance , and follow up action records . <br /> IN 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 /> The 2019 SCT and 2018 MSC have been included in the new compliance binders and will be onsite next <br /> week and are attached to be sent to the EHD . <br /> Page 2 of 3 <br /> Rev. 8/27/2019 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468 -3420 F 209 464-0138 1 www . sjcehd. com <br />