Laserfiche WebLink
Environmental Health Department <br />SA JOAQUIN <br />COUNTY --- <br />Corrective Action Statement <br />RE: April 01, 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 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 Paul Nso at (209) 468-3432 or pnso@sigov.orq. <br />Facility name: SUPER STOP GAS & LIQUOR` Submit completed form to: <br />Facility address: 290 N MAIN ST STE C SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10181339 ATTN: PAUL NSO <br />PR0231438 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #103 - Failure to submit and maintain complete and current financial responsibility documents. <br />Ive 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 />Vp Jow 1r2 K� wo _ - <br />Violation #209 - Failure to conduct the designated UST operator visual inspection at least once every 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: <br />DocAM&fT-S X92— Gt-jCt,os>� s,-+o+�,►�G,, w� �Ih��, <br />CF.(-71-Ff" T►jSPE-CT ojZ poIK3Gj THe Ttjcf,& crf,64 gV <br />µDnlTtl- -FobK�cF— mrw&j "P-1 L 4- MA -'i is <br />Page 2 of 2 <br />Rev. 8/27/2019 Stockton, California 95205 i T 209 468-3420 F 209 464-0138 www.sjc� hit crn► <br />1868 E. Hazelton Avenue � � <br />