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Environmental Health Department <br /> SAN . ..JOAQU IN <br /> �- OUNTY <br /> Corrective Action StatementR <br /> RE - April 17 , 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 <br /> Also, d e rl'b hat was done tc correct the violation in the space provided below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact Vicky an -Lee at (209) 616-3028 or vvang-lee@sjgov. org. <br /> Facility name - WOODBRIDGE GAS , MARKET & LIQUOR Submit completed form to: <br /> Facility address, 18806 N LOWER SACRAMENTO RD SJC ENVIRONMEN,TAL HEALTH DEP T E T <br /> CERS ID - 10181237 TT 1 ,, VI KY VANG-LEE <br /> PR0232388 1 868 E HELTJ AVENUE <br /> STOCKTON , CA 95205 <br /> iol do n #101 - Fad ure to obtai n a permit to operate from the EH D including but not limited to unpaid permit <br /> fees. <br /> This violation was corrected ❑ This violation will be corrected I (date) : <br /> ❑ Supporting documents included <br /> D fib actionstaken or will b taken to correct iol tion: � <br /> 4m&k-, bF C&Iup ISO tVAe Will 4wi-IL 47z) <br /> 9W <br /> � ) -e Fnej o A End e- 1*j,,e , <br /> Violation #104 - Failure to submit a complete and accurate UST Monitorinp Plant <br /> This violationwas corrected <br /> Th*ls violation will be corrected b (date): _ <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation. <br /> w <br /> i <br /> Violation #107 - Failure to submit and ainta*tn complete and current financial responsibility documents. <br /> El This violation was corrected 1:1 This violation will be corrected b (date) . _ <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> -sop <br /> Page 2 of <br /> Rev. 9/16/2020 <br /> 1868 E. Hazelton Avenue Stocktoji , California 95205 1 T 209 468-3420 M F 209 464-0138 1 www . j o . r 11EHD <br />