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'0 Environmental Health Department <br />Corrective Action Statement <br />RE: October 29, 2024, 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 form <br />with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br />Maria Lopez at (209) 616-3064 or melopez@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: MARIA LOPEZ <br />PR0231819 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #4 - 2010014 - Facility has submitted a complete and accurate UST Response Plan.. <br />Q This violation was corrected <br />Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />�_r �► L IL 1�I 1.0�i I� :i <br />Violation #5 - 2030041 - A current facility plot plan is maintained and has been submitted. <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 viol tion: \��� �(,� U 2, <br />0rnt n ,n t cy—, k() -ii 'rha am&'m <br />Violation #7 - 2010003 - Owner/Operator submitted DO form and/or informed the CUPA of any change(s) <br />within 30 days (TCR 10). <br />iThis 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: <br />Page 2 of 6 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue ( Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />