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S Q N J AQ U IN Environmental HWU rtment <br />COUNTY <br />MAY 18 ('u�, <br />Corrective Action Statement ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />RE: February 07, 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 />SHOP N GO 3, 4511 PACIFIC AVE, CERS ID: 10180943, PR0231216 <br />Violation #205 -Failure to submit and have current UST Monitoring Plan readily accessible at the facility. <br />This violation was corrected ❑ This violation will be corrected by (date): <br />❑ Supporting documents included (`P <br />r <br />Describe actions taken or will be taken to correct violation: I A <br />Violation #206 -Failure to submit and have a current UST Response Plan readily available on site. <br />l <br />�1 This violation was corrected ❑This violation will be corrected by,(date): <br />❑ Supporting documents included /� I <br />Describe actions taken or will be taken to correct violation: <br />Violation #210 -Failure to provide initial training, train every 12 months, and have a trained employee <br />present. <br />4 <br />Rev. 9 /1 612 0 2 0 <br />This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />�1 acl�� L�et�S✓1 ��- t.�; � r lc ��,�,� <br />Page 3 of 3 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />