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SAN 10AQUIN Environmental Health Department <br /> OUNTY <br /> Corrective Action Statement <br /> RE:July 19,2022,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 Stacy Rivera at(209)616-3043 or srivera@sjgov.org. <br /> BlackHawk Petroleum Inc.,5611 E WATERLOO RD,CERS ID:10180881,PR023i764 <br /> Violat <br /> ion#1118#118-Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within 30 days. <br /> C3' 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 /> w Violation#203-Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months. <br /> ' his 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 /> x.11 cye c�1 <br /> Violation#206-Failure to submit and have current UST Monitoring Plan readily accessible at the facility. <br /> his 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 /> Page 3 of 4 <br /> Rai 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 />