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SAN lOAQUIN Environmental Health Department <br /> " `�iTY <br /> Corrective Action Statement <br /> RE : December 02 , 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 . 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 /> Shewit Woldeareqay at (209) 468-0216 or stwoldearegavAslgov . orq . <br /> Facility name : NORTH POLE GAS & FOOD INC <br /> Submit completed form to : <br /> Facility address : 574 W GRANT LINE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> ATTN : SHEWIT WOLDEAREGAY <br /> CERS ID : 10181065 1868 E HAZELTON AVENUE <br /> PR0231405 STOCKTON , CA 95205 <br /> Violation #101 - Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees . <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 /> (ICE, it 11 1 14 I ) ITH ( ) � t� lC � � Tl � ci29 iKllv �n �'cL► � � � <br /> Violation #206 - Failure to comply with UST operating permit conditions . <br /> ❑ This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> � <br /> Describe actions taken or wi be taken to correct violation : � <br /> !4K I Iy�t ��� <br /> � i <br /> Page 2 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 . sjceh . com <br />