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SAN 10AQUIN Environmental Health Department <br /> CUUN i Y <br /> Corrective Action Statement <br /> RE. June 16, 2025, 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 /> Monica De Anda at(209)616-3063 or mdeanda@sigov.org. <br /> MOUNTAIN HOUSE CHEVRON, 1124 N INTERNATIONAL PKWY, CERS ID: 10926289, PRO54 <br /> Violation#14-2010018-Overfill prevention equipment inspection report form submitted to the UPA within 30 <br /> days. <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: —s- <br /> "e— � `/ <br /> ;' <br /> Violation#56-2030013-DO inspections completed at least every 30 days and meet all requirements(TCR <br /> 12). <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 orrect violati n: <br /> Volabon#59-2030001 -Records of release detection monitoring and maintenance properly maintained <br /> (TCR 9d). <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 /> s�v Go <br /> o f �(/�T C0 P <br /> Page 3 of 4 <br /> Rev SMW020 <br /> 1868 E. Hazelton Avenue I Stockton,California 952051 T 209 468.3420 1 F 209 464-0138 I www.sjgov.orglEHD <br /> ---------------------------- <br /> Scanned with <br /> m CamScanner-: <br />