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SAN S1GAQUIN Environmental Health Department <br /> COU W <br /> Corrective Action Statement <br /> RE;June 01,2023,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.Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any queslions,please <br /> contact Paul Ni at(209)856-3049 oT pnw@sjgov.crg. <br /> Facility name, HARNEY LANE AM PM Submit completed form te; <br /> Facillty address; 255 E Harney Ln SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS I4: 10484500 ATTN.PAUL NSO <br /> PR0537549 1868E HAZELTON AVENUE <br /> STOCKTON.CA 95205 <br /> Vlolatlon#206-Failure to comply with the designated operator inspection raquit ement9. <br /> A This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ support[ngdocuments Included <br /> Describe actions taken or will he taken to correct violation 'W�l� �.H UrG 71 a/1 dfs:vyhF ted <br /> 2 and !d /r deaced o arm Worn (/rl4'. <br /> rhs���ad r ar f�.t �aur/,>y 9, <br /> r'-tL�r,.-,ate pi d-t-Te rcr.mrrS. <br /> Violation#318-Failed to most spill container requirements. ? <br /> ❑ This violation was norrectetlu�Thia rA 0 z <br /> violation w111 be corrected by(date}: <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation 67.igi Co.-fi oL, <br /> r12.- e C/7�/� GCtofd"r�ci v,.n d4r - a?^�d / COeCifl Yi`7y�' <br /> L <br /> Page 2 0l2 <br /> Fn�r'tliFm>;o <br /> 1888 E.Hamitan Aver4ii iQdkl,Op,,G8111ofrlia 952051 T 209 468-34201 F 209 464-0138 I wwwslgov.orglEHD <br /> .L <br />