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SAN �� IIIN Environmental Health Department <br /> -COUNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: August 19, 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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: LOVES COUNTRY STORES OF CALIFORNIA#223 Submit completed form to: <br /> Facility address: 1553 COLONY RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184317 ATTN: KRISTINA SAETERN <br /> PR0516526 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> VThis 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 /> The signed DO will be signed in 72 hour going forward. Correct date for line tightness testing <br /> orrec e . <br /> Violation#209-Failure to maintain a copy of the"Facility Employee Training Certificate"on-site. <br /> V, 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 /> This has been corrected <br /> Violation#301 -Failure to operate UST system to prevent unauthorized releases including leaks,spills and <br /> overfills. <br /> VThis 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 /> This has been discussed and OK about 3 years ago and besides the point will get fixed <br /> when the CUPA issues permit for construction on this site. Permit has taken about over 8 months. <br /> Page 2 of 3 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />