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S Environmental Health Department <br /> Tv " ' NTY <br /> Corrective Action Statement <br /> RE : October 15 , 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 <br /> form with the Return to Compliance Certification within 30 days of inspection, if you have any questions, please <br /> contact Carol Presto at (209) 616-3061 or cpresto@sjgov.org. <br /> ARCO CHEROKEE GAS & MART*, 900 S CHEROKEE LN , CERS We 10180627, PR0231841 <br /> Violation #109 as Failure to submit "Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <br /> v This violation was corrected 0 This violation will be corrected by (date): "'4 e�)-D <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : ! e W 1 e c i n /L r lC� <br /> i3� M� @J1 ! 1 L3Pl ' JA e <br /> Violation #115 as Failure to submit "Monitoring System Certification Form" within 30 days of completion of the <br /> tests <br /> Poe'This violation was corrected 0 This violation will be corrected by (date): 1 '2r i 20 <br /> ❑ Supporting documents included 1 <br /> Describe actions taken or will be taken to correct violation : � rneler suns, 4z) <br /> z) <br /> l.VQ $ <br /> Violation #122 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> This violation was corrected 0 This violation will be corrected by (date): Z14J `2z <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : Ar /%e <br /> Glnd C9 I <br /> f7 etio Irl C 1 'MINIM 11 --� <br /> Page 3 of 4 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 I F 209 464-0136 1 www.sjgov.org/EHD <br />