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RECEIVEL7, <br /> Environmental Health DepaAde f <br /> SAN JOAQUIN ENVIRONMENTAL HEALTH <br /> {^ ' 1`1 f Y PERMIT/ SERVICES <br /> Corrective Action Statement <br /> RE : August 25 , 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 <br /> form with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please <br /> contact Paul Nso at (209 ) 468 -3420 or pnso@sjgov . org . <br /> Delta arco , 440 W DR MARTIN LUTHER KING JR BLVD , CERS ID: 10180903, PR0231055 <br /> Violation #118 - Failure to submit the " Underground Storage Tank Statement of Understanding and <br /> Compliance Form" . <br /> 0 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 : ���,�, ; �)1Q C) Cie f <br /> Violation #123 - Failure to submit the "Spill Container Testing Report Form" within 30 days after the test . <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 : � a �� ,`1 � �, 1 w0 ` yl h�nh e <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 : j , tip: d ka, 1L> , 1 , X12: <br /> Page 3 of 4 <br /> Rev. 8/18/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 F 209 464-0138 1 www. sjgov . org/ EHD <br />