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N40IIIN Environmental Health Department <br /> I�1 1J <br /> COUNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: June 02, 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: QUIK STOP MARKET#125 Submit completed form to: <br /> Facility address: 1580 W MAIN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180643 ATTN: KRISTINA SAETERN <br /> PR0231476 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> 11 This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Future Designated Operator inspections will be performed within the required timeframe to the extent <br /> possible. <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 />