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AN Q Q Q ( N Environmental Health Department <br /> - -- - C Q U iii T Y <br /> Greofiless groly s here . <br /> Corrective Action Statement <br /> RE : September 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 /> Paul Nso at (209) 616-3049 or pnso@sjgov. org . <br /> Facility name : NATIONAL PETROLEUM MANTECA Submit completed form to : <br /> Facility address : 2072 W YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181669 ATTN : PAUL NSO <br /> PR0231426 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation # 107 - Failure to submit and maintain complete and current financial responsibility documents . <br /> xThis violation was corrected ❑ This violation will be corrected by (date) : <br /> xSupporting documents included <br /> Describe actions taken or will be taken to correct violation : Original copy was attached with HMBP dated <br /> 03/31 /2021 in the folder . We printed separate copy of Financial Responcibility & CFO letter <br /> again and put in folder . <br /> Violation #202 - Failure to retain a paper or electronic copy of the permit to operate at the facility . <br /> ❑ This violation was corrected This violation will be corrected by (date) : 10/20/2021 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : We will request new copy from county EHD <br /> and put it on site as soon as received from county office . <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <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 : Mark appropriate box on Q11 on 8/27/21 report <br /> Page 2 of 2 <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 />