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SAN J OQQ Environmental Health Department <br /> ° a COUNTY <br /> Greotness grows here . <br /> Corrective Action Statement <br /> RE : February 14 , 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 Shewit Woldearegay at (209) 616-3063 or stwoldearegay@sjgov. org . <br /> Facility name : A&A GAS & FOOD MART Submit completed form to: <br /> Facility address : 16 E HARDING WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181239 ATTN : SHEWIT WOLDEAREGAY <br /> PR0231136 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 - Failure to submit and maintain complete and current financial responsibility documents. <br /> � � L / � yl J ;L3 <br /> Mr 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 /> A <br /> all <br /> Violation #122 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> Gl 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 /> r <br /> Q � <br /> issuea • /z <br /> �--3 <br /> Violation - Failure to submit and have current UST Monitoring Plan readily accessible at the facility. <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: <br /> Page 2 of 3 <br /> Rev. 9/18/2020 <br /> 1868 E. Hazelton Avenue I Stockton , California 95205 ( T 209 468-3420 F 209 464-0138 1 www. sigov . org/EHD <br />