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ti <br /> SA N1 DAQ U I N Environmental Health Department <br /> CQUINTY <br /> Greotness grows here. <br /> Corrective Action Statement <br /> RE: February 27, 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, describe what was done to 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 Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: GAS&SHOP Submit completed form to: <br /> Facility address: 1002 FRONTAGE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180637 ATTN:VICKY VANG-LEE <br /> PR0231604 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 /> ® 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: Fees were paid but not reflected in new billing system. <br /> cancelled check was provided and payment was found, a permit was issued. <br /> Violation#106-Failure to submit and maintain a current facility plot plan/site map. <br /> El 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: New map was put in and submitted on CERS <br /> previously. <br /> Page 2 of 3 <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 />