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i <br /> Environmental Health Department <br /> S A N 1 O A Q U I N <br /> CUUN I Y <br /> Corrective Action Statement <br /> RE : April 26 , 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 bebw each violation . Submit this <br /> completed form with the Retum to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact John Alaniz at (209) 616-3053 or jetanizi @sjgm .org , <br /> Facility name: FLAG CITY CHEVRON Submit completed form to: <br /> Facility address: 6421 CAPITOL AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180605 ATTN : JOHN ALANIZ <br /> PR0231706 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 will be taken to correct violation : <br /> This violation was removed . Please see attached . <br /> Vlolatbn #203 - Failure to maintain nwnitoring records for 36 months and maintenanoe records for W <br /> htorhFfs. <br /> 11 This violation was corrected ❑ This violation will be corrected by (date) : <br /> 6a Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> Please see attached fuel log that shows it was fixed & overfill test <br /> results for 87 and diesel . Record is on site . <br /> 1 <br /> Page 2 of 4 <br /> Rev. G/W2020 <br /> 1868 E . Hazelton Avenue 1 Stockton , Califomia 95205 1 T 209 468-3420 1 F 209 464-0138 1 www. sjgov . org/EHD <br />