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OAQUIN <br /> Environmental Health Department <br /> SANiJ <br /> C OL) N 'T Y . <br /> Corrective Action Statement <br /> RE : July 21 , 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@siqov. org . <br /> Facility name: KETTLEMAN CHEVRON Submit completed form to : <br /> Facility address : 601 E KETTLEMAN LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181435 ATTN : SHEWIT WOLDEAREGAY <br /> PR0231348 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #202 - Failure to maintain the " Facility Employee Training Certificate" on-site (after October 1 , <br /> 2018) . <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 : , S (,v o7' A— <br /> o r3 ec:v Y oU--�4� e4,�� . <br /> Violation #209 - Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days. <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 /> , 6.4L & eclt <br /> Page 2 of 2 <br /> Rev, 8/2712019 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464- 0138 1 www. sjcehd . com <br /> i <br />