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�' <br />SAN JOAPUIN <br />y <br />Environmental Health Dep«ai <br />Corrective Action Statement <br />RE: November 01, 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. <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 Gabriela Garcia-Mejia at (209) 616-3037 or ggarcia-mejia@sjgov.org. <br />Facility name: CHARTER WAY SHELL* Submit completed form to: <br />Facility address: 620 W DR MARTIN LUTHER KING JR BLVD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10181363 ATTN: GABRIELA GARCIA-MEJIA <br />1868 E HAZELTON AVENUE <br />PR0231058 STOCKTON, CA 95205 <br />Violation #122 - Failure to implement corrections and submit written response within 30 days of receiving the <br />report. <br />Un' This violation was corrected O'This violation will be corrected by (date): I f I Z 11-2-- <br />0- Supporting documents included <br />12 <br />Describe actions taken or will be taken to correct violation: Sii( !1 �►I l <br />A <br />D <br />L <br />Violation #208 - Failure to comply with the designated operator inspection requirements. <br />0/thisi <br />p This violation was corrected violation will be corrected by (date): <br />p' Supporting documents included �N� n <br />nacrriha actions taken or will be taken to correct violation: /'�'T <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/L <br />