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SANIOAQUIN Environmental Health Department <br /> COUNTY <br /> Corrective Action Statement <br /> RE : August 24 , 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 Gabriela Garcia- Mejia at (209) 616-3037 or ggarcia-mejia@sjgov. org . <br /> Facility name : Delta arco Submit completed form to : <br /> Facility address : 440 W DR MARTIN LUTHER KING JR BLVD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10180903 ATTN : GABRIELA GARCIA- MEJIA <br /> PR0231055 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 - Failure to submit and maintain complete and current financial responsibility documents . <br /> AThis violation was corrected ❑ This violation will be corrected by (date ) : <br /> ❑ Supporting documents included � ,, ,/ <br /> Describe actions taken <br /> 'o-r,�will _ <br /> be taken to correct violation : (�`d �o k;Ht ., <br /> Violation #109 - Failure to submit " Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days . <br /> IN 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 : pdr ,f'-rel {w. <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 />