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� # �� ! �� � H � k1 �l-a���� <br /> ���� �� � U�U � | �� <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 orwill bocorrected byacertain date. <br /> Also, describe what was done oocorrect the violation inthe space provided below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. |fyou have any questions, <br /> p|eanocontactLydiaDakorut(209)018'3U45or|buhor@sjgov.org. <br /> Facility name: ARCO STATION#83500° Submit completed form to: <br /> Facility address: 29O8VVBENJAMIN HOLT DR SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> ATTN LYDIA BAKER <br /> CERS |D� 1O181253 <br /> PR0231021 1858EHAZELTONAVENUE <br /> GTOCKT0N. CA 95205 <br /> Violation#101 -Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees. <br /> JB~-Thisviolation was corrected []This violation will be corrected by(date): <br /> O Supporting documents included <br /> Describe actions taken orwill botaken tocorrect violation: <br /> Violation#1V7'Failure»msubmit and maintain complete and current financial responsibility documents. <br /> �°~ v|o|a�ipnwosun,,ec�od []T�isxio|o�ionwU|hecunonou�by~�, . <br /> O Supporting documents included �f <br /> PM 010 <br /> Describe actions taken or will be taken to correct violation: <br /> ty F12 <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> 2~~fhiuviolation was corrected []This violation will be corrected by(date): <br /> O Supporting documents included <br /> Describe actions taken or will be taken to correct violation: ot�T 6v�e�? <br /> Pogo2cx2 <br /> Rev.9/16/2020 <br /> |SnOE �az�honAvonue | Stockton �m|i(wnim�5�05 { T 2094M8-3��O | F 209�G4-Ol�B <br />