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S A N JOAQUIN Environmental Health Department <br /> C... `> <br /> �J N i Y <br /> Corrective Action Statement <br /> RE: April 08, 2021, 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 Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: PERSHING GAS FOR LESS Submit completed form to: <br /> Facility address: 4445 N PERSHING AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181565 ATTN:VICKY VANG-LEE <br /> PR0231785 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <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: 1>yc_ do' CSU 1 j f1r7 ]'UL[ <br /> NS 101 C A 1 o r,,/ I w(kY ri/4 i^ Iwin m.AAc f v/1l- -A J)i 1 v , <br /> a ry J/Mc- /,j /=ul UPe. <br /> Violation#203-Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months. <br /> his 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: MOAT/i_0(L l•�l C<o It�1 /^d 2 �� /Ylp,�i� <br /> Ifir'� M/l)lN%e-1V19NCf ar(-b)0 Fat <br /> Raw,V1160020 Page 2 of 3 <br />