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SAN J OAN I N Environmental Health Department <br /> COUNTY <br /> Greatness grows here <br /> Corrective Action Statement <br /> RE: May 26, 2022, 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: GRANT LINE SHELL} Submit completed form to: <br /> Facility address: 2375 W GRANT LINE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10/81399 ATTN: CAROL.PRESTO <br /> PR0232469 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <br /> M This violation was corrected ❑This violation will be corrected by(date): 6/30/2022 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Submit update D.O.form to consulting company <br /> to update CERS profile. ,4� U,//// l'-of/ow /T 1} <br /> S 4 6 A 4 <br /> Violation#118-Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within 30 days. <br /> 6 This violation was corrected ❑This violation will be corrected by(date): 6/30/2022 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Ensure testing vendors are submitting test results <br /> within the 30 day timeline MOf! <br /> Page 2 of 6 <br /> Rev.9/1612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />