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U <br /> NEnvironmental Health Department <br /> 509JU A Q11 ,Fa� V Greatoess rows herC <br /> Corrective Action Statement <br /> RE: April 07, 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 /> Shewit Woldeareqay at(2091468-0216 or stwoldearegav0Dsig0v.orq. <br /> Facility name: ARCO AMIPM#83831* Submit completed form to: <br /> Facility address: 1904 DANIELS ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> ATTN: SHEWIT WOLDEAREGAY <br /> CERS ID: 10761034 1868 E HAZELTON AVENUE <br /> PR0541937 STOCKTON, CA 95205 <br /> Violation#103-Failure to submit and maintain complete and current financial responsibility documents. <br /> D This violation was corrected <br /> 2'This violation will be corrected by(date): ' <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: _ ,— <br /> wd+e daa LF.�Spent, <br /> Violation#209-Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days. <br /> ❑ This violation was corrected ErThis violation will be corrected by(date): jr4 TT,L6 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: T tall r"IL, T g* <br /> ' ae <br /> Violation#305-VPH monitoring of the interstitial spaces of the UST system is not maintained. <br /> e 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 /> AX <br /> Page 2of2 <br /> Rev.812712019 <br /> rnsf_„so otionr,i T 209 468-34201 F 209 464-0138 1 www.sjcehd.cam <br />