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S A N W O U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE:January 28, 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 Elianna Florido at(209)616-3050 or efiorido@s}gov.org. <br /> COUNTRY CLUB MOBIL CIRCLE K, 2575 COUNTRY CLUB BLVD, CERS ID: 10118074, PR023 <br /> Violation#313-Monitoring system incapable of detecting entry into secondary containment(post-Jul 2004). <br /> This violation was corrected /This violation will be corrected by(date): 3 ?� <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: _ UPTJ 4- r4-,-j �-AOtoi-roq-r,�e, <br /> JI-- l'r .-)" 4—A` V) r ?O hF <br /> C,E, S 44 Pt' J <br /> Violation#315-Failure to maintain Interstitial space to detect leaks before release to environment(post-Jul <br /> 2004), <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: n �.r� 54C r) �Ca►.ttir�4 r•.�4 <br /> .'31111r t s OP.& �o l.y, k IA/VS� 1KMJ,7 Q , A', <br /> Page 6 of 6 <br /> Rev,9/76/2020 <br /> 1868 E- Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s}9ov.org1EHD <br />