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SAN MARMARI I N Environmental Health Department <br /> corrective Action Statement <br /> RIE: January 25, 2321, Underground Storage Tank inspection report <br /> For each violation listed be'ow, ind:cme i`t`:e violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was dore to correct thU%Jclatiejr 1i the space provided be!ow each violation. Submit this completed form <br /> with the Return to Compliance C•srtifc!atior w thin 30 days of inspection. If you have any questions, please contact <br /> Stacy Rivera :' :r sri a. <br /> Facility narrie: ARCO 7-�3�60" Submit completed form to: <br /> Facility address: 22081N S "J Ar AIN H(.`I_-r �R SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS 0: ",13125-3 ATTN: STACY RIVERA <br /> CE <br /> PR0231021 -iEeg E 1-';`MELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#107-Failure to submit;,and rnaintaep.complete and current financial responsibility documents. <br /> This violation was ec--erted 0 This violation will be corrected by(date): <br /> Describe ac.lons taken ., wiii re talkr .tc correct violation: _ <br /> cwa &e44 Tb <br /> �'.ci 36.,no'nths and r1'iairiterlance records for 60 <br /> worths. <br /> ❑This violation will be corrected by(date): <br /> 1 <br /> Describe actions taker Ur'vJSi oe taken to c,,ec.vio;a ion: <br /> '1✓d(le'cliivn#208-Faa,,ura tc .v-*!-i desionatFd operator 1." spection requirements. <br /> r;.ii5 vior azxjn wii, Ue c,:irrec,'eci by(Orate): <br /> e i we aCi i tent . , ll(+11 Kr i r �nr ed o.ai10 <br /> Page 2of2 <br /> Rev.8/27/2019 <br /> 1 P,P� F. 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />