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h"""• SAN,,JOAQUIN Environmental Health Department <br />T. <br />COL) NTY <br />c' r C;reotness grows peri,. <br />Corrective Action Statement <br />RE: September 20, 2019, 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 />7 -ELEVEN INC #17334, 4501 N PERSHING AVE, CERS ID: 10165815, PR0231233 <br />Violation #124 - "Overfill Prevention Equipment Inspection Report Form" not submitted within 30 days of <br />inspection. <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 #201 - Failure to maintain monitoring, maintenance, and follow up action records. <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 #205 - Failure to submit a current UST Response Plan and have it available onsite. <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 3 of 3 <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 />