Laserfiche WebLink
SAN J O A Q U I N Environmental Health Department <br /> r; - COU NTY-- <br /> C;„ y Greatness gr�ow5 Frere. <br /> Corrective Action Statement <br /> RE: January 11, 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 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 Alberto Fernandez at(209)616-3037 or ALBERTO.FERNANDEZ@SJGOV.ORG. <br /> Facility name: KWIK SERV LODI BW 113' Submit completed form to: <br /> Facility address: 420 W KETTLEMAN LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181407 ATTN:ALBERTO FERNANDEZ <br /> PR0231906 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#102-Failure to submit a complete and accurate application for a permit to operate a UST. <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: <br /> Violation#104-Failure to submit a complete and accurate UST Monitoring Plan. <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: <br /> Violation#106-Failure to submit and maintain a current facility plot plan/site map. <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: <br /> Page 2 of 6 <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 />