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Environmental Health Department <br /> �.' SANh10AQUIN <br /> - �- '-COUNTY-_._ <br /> 6100tncss grov;s here. <br /> Corrective Action Statement <br /> RE:January 24,2023, 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. <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 g9 is s ov.or <br /> arcia-mej @ 19 g• <br /> Facility name: 76 EXPRESS TIGER NO 1 Submit completed form to: <br /> Facility address: 5777 S FRENCH CAMP RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182157 ATTN:GABRIELA GARCIA-MEJIA <br /> 1868 E HAZELTON AVENUE <br /> PRO505746 STOCKTON,CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> 9onThis violation was corrected ❑This violation will be corrected by(date): . <br /> 13 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> tz This violation was corrected ❑This violation will be corrected by(date): ��- jf <br /> ❑ Supporting documents included , A r�Lt.t�"/ <br /> Describe actions to en or will be taken to correct violation: �(f.(�,1�11U CId�E� <br /> Violation#308-Failure of the leak detection equipment to have an audible and visual alarm. <br /> 82 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 /> V <br /> D _ <br /> Page 2 of 3 <br /> Rev.9/16/2020 <br /> 1868 E.Hazelton Avenue I Stockton,California 95205 i T 209 468-3420 i F 209 464-0138 1 www.sjgov.org/EHD <br /> Created With Tiny Scanner <br />