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SAN 10ANIN Environmental Health Department <br /> Corrective Action Statement <br /> RE-.January 19, 2024, 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 data <br /> Also describe what was done to conect the violation in the space provided below each violation Submit this <br /> completed form with the Retum to Compliance Certification within 30 days of inspection If you have any questions, <br /> please contact Kristina Saelem at(209)616.3045 or ksaelern@sjgov org <br /> Facility name BILLJAR VALERO Submit completed form to. <br /> Facility address: 153 E ELEVENTH ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID, 10181331 ATTN'KRISTINA SAETERN <br /> PR0231389 1868 E HAZELTON AVENUE <br /> STOCKTON.CA 95205 <br /> Violation#101-Failure to obtain a permit to operate from the EHD Including but not limited to unpaid permit <br /> fees <br /> W This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included f <br /> Describe actions taken or will be taken to correct violation Pe-✓`��I 't X1.5 L._/L e- <br /> 6 + <br /> tCA I ✓n i K w Cr G <br /> Violation 0107•Failure to submit and maintain complete and current financial responsibility documents. <br /> PJ This violation was corrected ❑This violation will be corrected by(date): <br /> Supporting documents Included L� <br /> Describe actioonstaken or will be taken to correct violation ` _u <br /> O L"\ 11,577�S' <br /> - <br /> Vlolation 0117-Failed to submit"Secondary Containment Testing Report Form"within 30 days atter the test. <br /> K This violatlon was corrected ❑This violation will be corrected by(date): <br /> jQ Supporting documents Included <br /> Describe actions token or will be taken tocorrectviolation 1 ; YAC� <br /> L <br /> ykci ' <eof cue%^ Ve. LA �+VG GAe+n 4,4.i,nizXx <br /> pL"ej tC5,4 fro! - <br /> Page 2 of 3 <br /> a..a+rnio <br /> 1866 E Hazelton Avenue I Stockton,California 952051 T 209 468-34201 F 209 464-0138 1 www sjgov.orVEHO <br />