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SAN J O A n U I N Environmental Health Department <br /> - - COUNTY - - <br /> ` 1r ; ,� Greatness grows here . <br /> Corrective Action Statement <br /> RE : July 11 , 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 /> Lynsey Sammons at (209 ) 616 -3067 or Isammons@sjgov. org . <br /> Facility name : NORCAL FUELS Submit completed form to : <br /> Facility address : 3300 N WEST LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181477 ATTN : LYNSEY SAMMONS <br /> PR0231289 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #4 - 2010014 - Facility has submitted a complete and accurate UST Response Plan . . <br /> ❑ This violation was corrected This violation will be corrected by (date) : <br /> ❑ Supporting documents included ,, 1 <br /> Describe actions taken or will be taken to correct violation : 1 " L"V )'Cu � r� 4i 1 ✓L <br /> lnlill., ( AGth M !>j 0 /ice 1 �Pl,c f� l� +U 4 <br /> Violation #10 - 2030074 - Annual Monitoring System Certification Form to the CUPA within 30 days of <br /> completion of the test. <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 : l <br /> 11 14 A6116C GJU A Alt, 4j , � lix; E JY4 � Q / AIAf i L.19ibl P Ciir� �?Ili �[J <br /> Page 2 of 4 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue 1 Stockton , California 95205 1 T 209 468 -3420 1 F 209 464-0138 1 www.sjgov .org/EHD <br />