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Environmental Health Department <br /> SAN4JOAQUIN <br /> t* 16& E — COUNTY <br /> Greatness grows he ,- e . <br /> Corrective Action Statement <br /> RE : January 11 , 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 Paul Nso at (209) 616-3049 or pnso@sjgov. org . <br /> Facility name : ARCO 06080 Submit completed form to : <br /> Facility address : 85 E LOUISE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181263 ATTN : PAUL NSO <br /> 1868 E HAZELTON AVENUE <br /> PR0231656 STOCKTON , CA 95205 <br /> Violation #115 - Failure to submit " Monitoring System Certification Form" within 30 days of completion of the <br /> test. <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 /> Test documents completed on 1/ 19 /21 were emailed to ust (cDs " gov org on 2 / 12 /21 A date stamp of the email <br /> and test results are attached . <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 /> See email thread between Inspector Carol Presto and me dated on 9/ 13 /21 pertaining to violations noted <br /> during 1/ 19 /21 inspection Though the Return to Compliance form was completed late Gettler- Ryan responded <br /> II <br /> to the violation on 2 / 1/21 According to Inspector Presto the site returned to compliance on 9 / 13 /21 . <br /> Page 2 of 2 <br /> Rev. 9/16/2020 <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 />