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S A NJ 0 A 0 U I N Environmental Health Department <br />;w " CQUN7Y- <br />it)r Greatness grows here. <br />Corrective Action Statement <br />RE: October 27, 2022, Hazardous Materials 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: ARCO AMPM <br />Facility address: 2056 CRESTWOOD AVE <br />CERS ID: 10842625 <br />PRO545896 <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: PAUL NSO <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #6 - Failed to electronically submit a site map with all required content. <br />PC This violation was corrected 13 This violation will be corrected by (date): <br />0 Supporting documents included <br />Describe actions taken or will be taken to correct violation: j5yc(r Rf -ns A-� <br />(10 AAA-P&ajL0-45i, tr 2Nf� but S t E A-i� w5 , <br />iry Pte+ rJ h ipll� is #JoTaeo <br />Violation #10 - Failed to electronically update the HMBP within 30 days of substantial change in operations. <br />PF This violation was corrected 13 This violation will be corrected by (date): <br />0 Supporting documents included <br />Describe actions taken or will be taken to correct violation: J+M F39 l S 6,14 R X j\M I M <br />Page 2 of 2 <br />