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SKJOAQUIN Environmental Health Department <br /> _ . <br /> COUNTY---- <br /> AS <br /> 0, <br /> I _ Greatness arows her,.. <br /> Corrective Action Statement <br /> RE: October 17, 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 /> Facility name: ARCO AM PM#82602` Submit completed form to: <br /> Facility address: 2430 JOE POMBO PKWY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182265 ATTN: PAUL NSO <br /> PRO506796 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#103-Failure to submit and maintain complete and current financial responsibility documents. <br /> )m 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: C/L✓ri e/ S v�..,., � <br /> crr'rc C.-� ✓� �G � -. .S'�.1�C in,.�,"r oma- 1 I-!°/-/ -r <br /> Violation#118 -Failure to submit the "Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <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 3 <br /> Rev.827/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />