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M � I � Environmental Health Department <br /> u <br /> '- -COUNTY— <br /> Greatness <br /> COUNT <br /> Greatness grows here, <br /> Corrective Action Statement <br /> RE: December 13, 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. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Shewit Woldearegay at(209)616-3063 or stwoldearegay@sjgov.org. <br /> Facility name: 7-ELEVEN INC#20632 Submit completed form to: <br /> Facility address: 4627 DA VINCI DR SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10165883 ATTN: SHEWIT WOLDEAREGAY <br /> PR0231074 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#101 -Failure to obtain a permit to operate from the EHD including but not limited to unpaid <br /> permit fees. <br /> 0 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: Future permit renewal invoices to be completed <br /> once as soon as received by company. <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> ® 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: DO placed FR document onsite during most recent <br /> inspection (1/5/23). <br /> Page 2 of 3 <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 />