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SAN-JOAOUIN <br /> Environmental Health Department <br /> . � <br /> COU <br /> N T Y---, <br /> Corrective Action Statement <br /> RE: April 27, 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: FLAG CITY CHEVRON Submit completed form to: <br /> Facility address: 6421 CAPITOL AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180605 ATTN: SHEWIT WOLDEAREGAY <br /> PR0231706 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#106-Failure to submit and maintain a current facility plot plan/site map. <br /> ❑ This violation was corrected [This violation will be corrected by(date): TL)rgA� <br /> ❑ Supporting documents included 2.272.3 <br /> Describe actions taken or will be taken to correct violation: �� 1x191 l tri '� CeRS <br /> U97- Nlonl'(prrnq Sly NCLO . <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> XThis violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included t <br /> Describe actions taken or will be taken to correct violation: ()-) 'ensu t G 4+9 Com! <br /> Page 2 of 3 <br /> Rev.9/1612020 <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 />