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S H N 3J U H Q U N 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 /> Delta arco , 440 W DR MARTIN LUTHER KING JR BLVD , CERS ID : 10180903 , PR0231055 <br /> Violation #118 - Failure to submit the "Overfill Prevention Equipment Inspection Report Form" within 30 days . <br /> J! This violation was corrected ❑ This violation will be corrected by (date ) : <br /> ❑ Supporting documents included 1 <br /> Describe actions taken or will be taken to correct violation : �j(� /,�� p�(� l'►it�) © N <br /> /li► C 44%Q <br /> Violation #206 - Failure to submit and have a current UST Response Plan readily available on site . <br /> 16 This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> � A � <br /> Describe actions taken or will be taken to correct violation : e �kGI I h <br /> ikQJut 1 &6 e <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> Al 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 : mo o �1 .4 /✓q'�d <br /> / C%JS- l ij 121Z <br /> Page 4 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 />