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SAN JOAQIJIN Environmental Health Department <br /> COUNTY <br /> Greatness grows h, <br /> Corrective Action Statement <br /> RE: November 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. 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. A&A GAS FOOD MART Submit completed form to: <br /> Facility address: 1330 E YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184191 ATTN: PAUL NSO <br /> PRO515864 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#107 -Failure to submit and maintain complete and current financial responsibility documents. <br /> 13 This violation was corrected 13 This violation will be corrected by(date): <br /> 02,f 2- <br /> 13 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> it C• i� reS 06 N.S I ij Lid v U vA- <br /> C't n C i7 a b I at <br /> �� i��`m <br /> rt L } (26 f s 3 S aka 6,1 -1 p o -� t-5 r l ►�.5 b e �"� yte-�= <br /> Violation#203-Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months./ <br /> D <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: 7Le r' �n oVyl/b,(/ <br /> rl�� �l�vr�/ �� ��-G ��r 4/-�1i• <br /> Violation#206-Failure 1'o submit ari/d have current UST Monitoring Plan readily accessible at the facility. <br /> Q/--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: �/ 3 <br /> � /. f�G✓ ✓1 GI Ale- & 402 v-s°EG/ G 4 �rS ;6- Gv->1 Mei <br /> dz1)r I /-j�/ C e,U'0 aT Z cjS r xolo'-) <br /> Dh f�-S .� fir► �' �a �' V?f-s'4- <br /> Page <br /> f Page 2 of 3 <br /> Rev 9/16/2020 <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 />