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SANI O I I I Environmental Health Department <br /> .PCOUNTY <br /> �G Greornes3 grows here- <br /> Corrective Action Statement <br /> RE: August 08, 2023, 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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: Pilot Travel Center Lathrop- 1017 Submit completed form to: <br /> Facility address: 345 Roth Rd SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10726990 ATTN: KRISTINA SAETERN <br /> PR0540987 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#317-Failure of the line leak detector to detect a 3.0 gph leak at 10 psi and restrict or shut off flow. <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: A permit was obtained and approved on August 24, 2023. <br /> The repair was completed and tested on November 9, 2023. A copy of the Work Order and Passing Monitor Cert is included. <br /> Page 2 of 2 <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 />