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� �� u� Environmental Health Department <br /> A —:C U N T Y <br /> i . <br /> Greato ss grows here, <br /> Corrective Action Statement <br /> RE: June 22, 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 /> Stacy Rivera at(209)468-3440 or srivera(a_sigov.orq. <br /> RANCHO SAN MIGUEL MARKET*, 1427 S AIRPORT WAY, CERS ID: 10184829, PR0521942 <br /> Violation#207-Failed to record unauthorized release from primary containment. <br /> 63 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: The form record unauthorized release has <br /> been filled out. will keep a copy in the binder and will submit a copy with the letter of correction. <br /> Violation#209-Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days. <br /> GI 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: Karen Arnaiz our D.0 will ensure that all notes <br /> and information is reported on the monthly report. <br /> Violation#331 -Liquid does not flow into the sump in the event of a leak(i.e.,failure to remove test boot).. <br /> EZ 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: Service Station Systems Loosen the Boots <br /> Shrader Valve was corrected. a copy of the work order will be onsite and a copy will be mailed with <br /> the letter of correction. <br /> RECEIVED <br /> J U L 06 2G23 <br /> LNN'llR0N IENT.k1, I11-::\I,T1I <br /> Page 3of3 DFP.kRI IE\ I' <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 />