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SANJOAQUI Environmental Health Department <br /> COUNTY <br /> t�c, v Greatness grows here. <br /> Corrective Action Statement <br /> RE: August 03, 2020, 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(209)468-3440 or srivera(a)sigov.orq. <br /> Facility name: QUIK STOP MARKET#7039 Submit completed form to: <br /> Facility address: 2285 E FREMONT ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180797 ATTN: STACY RIVERA <br /> PR0231111 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#103-Failure to submit and maintain complete and current financial responsibility documents. <br /> ff 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 /> Financial responsibility documents provided to DO to maintain onsite and are included in the new site <br /> binders. <br /> Violation#201 -Failure to maintain monitoring, maintenance, and follow up action records. <br /> IN This violation was corrected ❑This violation will be corrected by(date): <br /> N Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> SCT from 10/31/2019 and MSC from 8/15/2019 have been provided to DO to maintain onsite and are <br /> attached. Missing work order from 10/31/2019 is attached and has been submitted into new binder that <br /> will e going out to site. <br /> Violation#202-Failure to maintain the"Facility Employee Training Certificate"on-site(after October 1, <br /> 2018). <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 /> Training certificate has been updated with CERS ID and DO telephone number and is attached. <br /> Page 2 of 4 <br /> Rev.8/27/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />