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s <br /> SAN lJOAQUIN Environmental Health Department <br /> U N T 1' <br /> Corrective Action Statement <br /> RE: May 27, 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 Paul Nso at (209 ) 468-3432 or pnso@sjgov .orq . <br /> DBA CIRCLEK, REFUEL PETROLEUM INC. , 419 S MAIN ST, CERS ID: 10181307, PR0231433 <br /> Violation #121 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> 2 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 /> ( A ) 1Lit 2G ` ccy 'T r . 9iT"4fIN <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 /> Sj%j " - W 1U . ,arc o iJ ►I tom £ iN `i li f rely� � 4 <br /> Violation #201 - Failure to maintain monitoring , maintenance, and follow up action records. <br /> R 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 5 <br /> Rev, 8/27/2019 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www . sjcehd. com <br />