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�l ►I��aAl I I N Environmental Health Department <br /> L-'r.`' j C:O U N T Y <br /> r o- Greotness grows here. <br /> Corrective Action Statement <br /> RE: May 07, 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 Shewit Woldearegay at(209)468-0216 or stwoldearegay(o),sigov.orq. <br /> Facility name: TOKAY SHELL Submit completed form to: <br /> Facility address: 420 W KETTLEMAN LN# 1 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10767814 ATTN: SHEWIT WOLDEAREGAY <br /> PR0544259 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#103-Failure to submit and maintain complete and current financial responsibility documents. <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 /> Violation#104-UST operating permit application for facility and tank information not submitted or current. <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 /> 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 /> Describe actions taken or will be taken to correct violation: <br /> Page 2 of 6 <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 />