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SAN �� IIIN Environmental Health Department <br /> -COUNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: April 28, 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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: JAHANT FOOD N FUEL STOP Submit completed form to: <br /> Facility address: 24323 N HWY 99 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181611 ATTN: KRISTINA SAETERN <br /> PR0231947 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#102-Failure to submit a complete and accurate application for a permit to operate a UST. <br /> ❑D❑ This violation was corrected ❑x ❑This violation will be corrected by(date): 5/27/22 <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: In Review with Inspector <br /> Violation#104-Failure to have an approved UST Monitoring Plan. <br /> ® This violation was corrected ®This violation will be corrected by(date): 5/22/22 <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Logged onto CERS and made the necessary <br /> .changes for the UST Tank Information/Monitering Plan <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): 5/22/22 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: The current Financial Responsibility <br /> Documents have been submitted to CERS, and kept on Site. <br /> Page 2 of 4 <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 />