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SAN U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: March 30, 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 <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Carol Presto at(209)616-3061 or cpresto@sjgov.org. <br /> Facility name: LAKEWOOD CHEVRON Submit completed form to: <br /> Facility address: 236 N HAM LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181333 ATTN: CAROL PRESTO <br /> 1868 E HAZELTON AVENUE <br /> PR0231333 <br /> STOCKTON, CA 95205 <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> This violation was corrected ElThis violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> � V-\ Tj �wee <br /> Page 2 of 2 <br /> Rev.9116/2020 <br /> 1868 E. Hazelton Avenue 1 Stockton. California 95205 1: T 209, 468-3-120 1 F 209464-0138 j www.sjgov.org/EHD <br />