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SAN JOAQUIN <br /> Environmental health Department <br /> Corrective Action Statement <br /> RE : January 21 , 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 . Also , <br /> describe what was done to correct the violation in the space provided below each violation . Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please contact <br /> Stacy Rivera at or srivera(@sigov .orq . <br /> Facility name : COSTCO WHOLESALE #658 Submit completed form to : <br /> Facility address : 3250 W GRANT LINE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10146285 ATTN : STACY RIVERA <br /> PR0518288 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #203 - Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months . <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 /> Part 1 -Secondary containment test was emailed it to the inspector at the time of inspection . In the future , we will make sure to have this on site . <br /> Part 2 -The alarm logs will be accurately tracked in the future <br /> Violation #305 - Failed to maintain secondary containment (e .g . failure of secondary containment testing ) . <br /> ❑ This violation was corrected ® This violation will be corrected by (date ) : TBD ( Permit Pulled ) <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> Wayne Perry Inc. sent the permit application request to County EHD on 01 /15/2021 . As of 02/ 18/2021 the permit is being <br /> processed this week . The work will be done as soon as possible . <br /> Violation #319 - Failure to comply with overfill prevention equipment requirements . <br /> ® This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> i <br /> Describe actions taken or will be taken to correct violation : <br /> We currently have passing testing dated 09129/2020 . We will make sure the information is accurate in the future . <br /> f Page 2 of 2 <br /> Rev_ 8 /27/209 <br /> i <br /> 1668 E , HaZelion N en 'io I Ster;ktun . Cal foml, ( i 9520a ( T 209 468 -3420 F 209 464 - 0138 i wvvw . sjcehd .c0m <br />