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S A N J O A Q U I N Environmental Health Department <br /> C0LjN TY <br /> Corrective Action Statement <br /> RE: March 21, 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. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions,please <br /> contact Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: CALIFORNIA STOP* Submit completed form to: <br /> Facility address: 2224 MANTHEY RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181299 ATTN: PAUL NSO <br /> PR0232555 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#118-Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within 30 days. <br /> $I 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: IN e__ Y-L .> L? <br /> -'t hh-)- fi r c- -1(-. r'a.ac,1- .,a , ) 1 bc- 3,A b aa , 4-4c--t <br /> on -+ ,rn(-, ,,j . ---r,, 30 c I rn!:3,> , <br /> Violation#203-Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months. <br /> IN 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: e r ,^ -)e c cn h C, <br /> s-wr-e N 4 i 01 -trla- P-,— fi, v,*e-d i�! <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <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: W:] 1 Al L. lgl <br /> A 0 nr• ru-^Iv� <br /> cl- 9 <br /> k r.�./J i CA <br /> Page 2 of 3 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/EHD <br />