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SAN JOAQUIN Environmental Health Department <br /> C ( iNTY <br /> Corrective Action Statement <br /> RE: August 15 , 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 : GAVINKO PETROLEUM * Submit completed form to : <br /> Facility address : 7700 MORELAND ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181359 ATTN: SHEWIT WOLDEAREGAY <br /> PR0231819 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 - Failure to submit and maintain complete and current financial responsibility documents . <br /> b 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 : �,� i / P ��inn /, �I� L Oi'( �ryG(aC, <br /> Violation #115 - Failure to submit " Monitoring System Certification Form " within 30 days of completion of the <br /> test. <br /> E� 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 : tzl Jif/Le Su t +e- lS (Ze�rarfr <br /> r <br /> Q1441j611 eajA4 <br /> Page 2 of 5 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468 -3420 1 F 209 464 -0138 1 www. sjgov . org/ EHD <br />