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Parkwood Gas& Food 2098888157 p.2 <br /> P91V <br /> SAN JDAQUIN <br /> Environmental it pain lent <br /> JUL 01 2020 <br /> ENVIRONMENTAL HEALTH <br /> Corrective Action Statement PERMIT/SERVICES <br /> RE: June 17, 2020, 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 dale_ <br /> Also, describe what was done to correct the violation in the space provided below each violation. Submit thi!; <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any qu�_!Aions, <br /> please contact Paul Nso at(209)468-3432 or pnso@sjgov.org. <br /> Facility name: TIWANAGAS & FOOD Submit completed form to: <br /> Facility address: 1210 E HAMMER LN SJC ENVIRONMENTAL HEALTH DEPEkF;TMENT <br /> CERS ID: 10181355 ATTN: PAUL NSO <br /> PR0231125 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#104-UST operating permit application for facility and tank information not submitted or current. <br /> EK 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 /> Violation #205 - Failure to submit a current UST Response Plan and have it available onsite. <br /> EX This violation was corrected ❑This violation will be corrected by (date), _. <br /> EY"/Supporting documents included _ -I <br /> Describe actions taken or will be taken to correct violation: �— 1'-1 �� v Q U�'q <br /> 17 <br /> Violation#209- Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days. <br /> G2/ This violation was corrected ❑ This violation will be corrected by (date): <br /> ❑ Supporting documents included <br /> r� <br /> Describe actions taken or will be taken to correct violation: � �� ( i'}')G r�� SC)f Z-- <br /> I <br /> Co�� ✓G� �vrC Gi 4_�v <br /> Page 2 of 2 <br /> Rev.8/2712D19 <br /> Received Time Jul, 1, 2020 9: 03AM No, 6070 <br />