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2020 - 06 - 23 14 : 05 TRACY TRUCK STOP 12098322312 > > P 5 / 17 <br /> 14 1 Health <br /> ¢ <br /> �. � . .,, �,. Ctl,t,ti. :. :' � ifEnvironmentalIIeaIga Rh Department <br /> AN J0 :AQ 0 d <br /> : , Q t.1 � TY <br /> . , <br /> C:` `% / ' � rejti2tnV:SC : gtgsus f7tdr?, <br /> Corrective Action Statement <br /> RE , April 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 /> Shewlt Woldearegay at (209 ) 468-0216 or stwoldearegayPslaov. orq . <br /> TRACY TRUCK AND AUTO STOP , 3940 N TRACY BLVD, CERS ID : 10182335 , PROS07837 <br /> Violation #124 - "Overfill Prevention Equipment Insparetion Report Form " not submitted within 30 days of <br /> inspection. <br /> L}oe*� Thls 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 : to <br /> A t rt o, <br /> Violation #201 - Failure to maintain monitoring , maintenance , and follow up action records. <br /> 0 Thls violation was corrected 0 This violation will be corrected by ( date) : <br /> ❑ Supporting documents Included <br /> Describe actions taken or will be taken to correct violation : Ll <br /> od ( o V1 ( .� Xyl / K/� C� fC 0 Ut wt n r) t—c�� ( C, <br /> Violation #209 - Falluro to conduct the designatod UST operator visual Inspection at toast once evory 30 <br /> days . <br /> la This violation was corrected C3 This violation will be corrected by (data) ; <br /> ❑ Supporting documents Included I <br /> Describe actions taken or will be taken to correct violation ; 'rl r (jrA -t a pv\ r ,�) CIA <br /> 1> OA to-PL) J C� ,n�. 6V� P A X, <br /> Pago 3 of 3 <br /> Rnv, 6/27/2019 <br /> 1868 E , Hazelton Av�an � �A 1 Cztnnktnn rnur^ rnli 952051 T 209 468m34201 F 209 4640138 1 www . sjcehd , com <br /> Received Time Jun . 23 . 2020 4 : 50MNo . 6046 <br />