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r, SIN <br /> ANJ 0 AQ I I Environmental Health Department <br /> i'� COUNTY <br /> Greatness grows here. <br /> Corrective Action Statement <br /> RE: January 19, 2023, Aboveground Petroleum Storage Act 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: EFUEL, LLC RIPON FACILITY Submit completed form to: <br /> Facility address: 777 S LOCUST AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10869256 ATTN: KRISTINA SAETERN <br /> PR0546862 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#103-Failed to file HMBP or annual facility tank statement. <br /> CX 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 /> Item 103:The annual tank statement was submitted on January 19, 2023. <br /> Item 610:The phone number for SJC EHD was updated in the SPCC plan and corrected durinq the inspection. <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 />