COMPLIANCE INFO_2022 - Laserfiche WebLink

Home Browse Search

t a E Corrective Action Statement RE : March 14 , 2022 , Underground Storage Tank inspection report For each Violation listed below, indicate if the violation has been corrected or will be corrected by a certain date . Also , describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection . If you have any questions, please contact Carol Presto at 09616-3061 or cprestosigovorg , Facility name: _P_LAZA_LI(LUOR #1 Submit completed form to: Faci i address : 800 S CHEROKEE N SJC ENVIRONMENTAL HEALTH DEPARTMENT C�ERS.JJO� 10181567 ATTN: CAROL PRESTO PR0231325 1868 E HAZELTON AVENUE f STOCKTON , CA 95205 Violation #115 - Failure to submit " Monitoring System Certification Form" within 30 days of completion of the test. E This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation : ` V C1-\AQP. L Violation #116 - Failure to submit the "Spill Container Testing Report Form" within 30 days . D This violation was corrected ❑ This violation will be corrected by (date) : ❑ Supporting documents included Describe actions taken or will be taken to correct violation : x y' C \ 1L �yIL ( �•,' �i c k , s1 _ t l � VC .l c \ 1c � <4 C � � L AI t - ct� � \t" {} C .} wrc>u � tV\ \tc V � c `olo \. 0 �4V;, 40 c� r,1 � Wn C � V\ o� Violation #117 - Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test. ❑' This violation was corrected ❑ This violation will be corrected by (date) : ❑ Supporting documents included Describe actions taken or will be taken to correct violation : i .t c wnC1 4 C;e1 tt _ Page 2 of 3 Rev 9/ M2020