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SAN J O AQ U I N Environmental Health Department <br /> Ccl.Jr <br /> Corrective Action Statement <br /> RE: May 18, 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 below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact Elianna Florido at(209)616-3050 or eflorido@sjgov.org. <br /> Facility name: SUSD-CORPORATE YARD Submit completed form to: <br /> Facility address: 1932 EL PINAL DR SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181573 ATTN: ELIANNA FLORIDO <br /> PR0231097 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#104-Failure to have an approved UST Monitoring Plan. <br /> ® This violation was corrected ❑This violation will be corrected by(date): <br /> C Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Current responce plan uploaded on CERS,for the <br /> UST Tank#TA0506338 and Tank#TA0506339. <br /> TS-550-evo <br /> Violation#105-Failure to have an approved UST Response Plan. <br /> Cl 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: _Log on CERS and update the Primary Emergency <br /> Coordinator Name . New Coordinator Name: Tabatha Hoak Manager, Mechanical Division (SUSD). <br /> Consolidate Emergency Response/Contingency Plan and Business Owner/Operator Identification <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <br /> Cl 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: Form loaded on CERS 5/18/2021 <br /> Page 2 of 4 <br /> Rev.9116/2020 <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 />