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:� Nj;jtwj <br /> SAN 1UQQUIN Environmental Health Department <br /> Ix ' . <br /> • at .' - COUNTY - <br /> _ <br /> `��! /F �a�`. �irC• otness yrov. s here , <br /> Corrective Action Statement <br /> RE : May 28 , 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 . 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 /> Shewit Woldearegay at (209) 468-0216 or stwoldearegay@sjgov. org . <br /> MORADA CHEVRON FAST N EASY #60* , 10878 N HWY 99 , CERS ID : 10180717 , PR0231598 <br /> Violation #107 - Plot plan /site map not submitted or failed to completely show where monitoring is <br /> performed . <br /> ❑ This violation was corrected This violation will be corrected by (date) : I Z <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : wLAJ <br /> Violation #111 - Failed to test monitoring and leak detection equipment every 12 months . <br /> 91 This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> Descri e actions taken or will be taken to correct violation : <br /> Violation #118 - Failure to submit the " Underground Storage Tank Statement of Understanding and <br /> Compliance Form " . <br /> CThis 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 /> i Ad 00A Le OVA LFJ�(S <br /> Page 3 of 6 <br /> Rev. 8/27/2019 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www. sjcehd . com <br />