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RECEIVED VIA EMAIL ON 04-11-2022 <br /> SAN OAQU I N �7��7' 0D T7 -,-)'�=C Health Department <br /> COUNTY - <br /> Corrective Action Statement <br /> RE:April 05, 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 Vicky Vang-Lee at(209)616-3028 or Wang-lee@sjgov.org. <br /> Facility name: JACKSONS ENERGY#6822 Submit completed form to: <br /> Facility address: 2132 MARIPOSA RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180759 ATTN:VICKY VANG-LEE <br /> PR0231669 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#203-Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months. <br /> L—� This violation was corrected 0 This violation will be corrected by(date): <br /> lY/ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> reC%A► -S himve been e10,,ct,A onS��e, mese }etk rP.cKl-}S uce: wlSn ,fIc low <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 />