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SAS JUI Environmental Health Department C_0U T Y, Corrective Action Statement RE: January 22, 2020, Underground Storage Tank inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Paul Nso at(209)468-3432 or pnso@sjgov.org. Facility name: ARCO STATION#83560'` Submit completed form to: Facility address: 2908 W BENJAMIN HOLT DR SJC ENVIRONMENTAL HEALTH DEPARTMENT CERS ID: 10181253 ATTN: PAUL NSO PR0231021 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Violation#103 -Failure to submit and maintain complete and current financial responsibility documents. ,0'This violation was corrected ❑This violation will be corrected by(date): ❑ Supporting documents included — a Describe actions taken or will be taken to correct violation: � [gry►I h --��. t-0 sViIV'-(, W10 &V-0 M i I Ce tv cl:� Violation#105 -Failed to have an approved UST monitoring plan. .2--This violation was corrected ❑This violation will be corrected by(date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: rl �D 1- t��hrf� lib 9 0 0_A iiCx fib CMYLS. Violation#113-Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test. ,S'This violation was corrected ❑This violation will be corrected by(date): ❑ Supporting documents included �,, Describe actions taken or will be taken to correct violation: ( ,(,�,�`121 �t, � i�7��`t IT1 Wk0 Li -d rD CS, Page 2 of 4 Rev.8/27/2019 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com I