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Environmental Health Department <br /> SAS ��� <br /> $ reotness vows here. <br /> Corrective Action Statement <br /> RE: February 18, 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: SHELL FOOD MART Submit completed form to: <br /> Facility address: 2320 N EL DORADO ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182111 ATTN:VICKY VANG-LEE <br /> PR0231084 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 wi I be taken to correct violation: �� J V vol Cj. 0 0 <br /> > ` <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> WThis violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Desc ibe actions taken or will betaken to.correct violation: <br /> A-bTrn � 6 <br /> --,-(r) (-�,4N <br /> � eS <br /> Violation#209-Failure to maintain a copy of the"Facility Employee Training Certificate"on-site. <br /> sVhis violation was corrected ❑This violation will be corrected by(date): <br /> upporting documents included <br /> Describe ac ions taken or will be take`to corre t viol tion: <br /> 10--t Nd- 4V& Y� Ce— <br /> Rev.9/16/2020 Page 2 of 2 <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 />