Laserfiche WebLink
r _ A , O I Environmental Health Department <br /> Corrective Action Statement <br /> RE May 21 , 2020, Underground Storage Tank inspection repert <br /> For each, violation listed below, Indicate If tho o6olation has boon eorEact&d or be corrected by acertain data. Also , <br /> describe what was done to correct the violation In the space provided below each Violation , 80mit this completed forth <br /> with the. Return to Compliance Cfattificalion within 20 mays of inspection. If you frava any questions, pleasa contaol <br /> Shff%v t 'Noldearaday al! (209) 468 0216 or sL%voltjF3arf3£]a`IIC&sjgf v1orq. <br /> Facility name; CCSTCO WHOLESALE #1001 submit cornplowd form too <br /> Far_,-ility address; 2663 REYNOLDS RANCH PMVY Si C: ENVIRONMENTAL HEALTH DEPARTMENT <br /> GERS la_ 10146151 ATrN: SHEWIT WOLDEAREGAY <br /> PR0535432 186B E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #103 = Failure to subunit and maintain comptats and current financial responsibility documents& <br /> 11A This violation was corrattcd 0 This violaUon will be corractad by (date) : <br /> 8 Supporting documents included <br /> esGriba actions takprl or will t � taken to correct viola#ivo <br /> nvYt` N1 P mf el 0 r901L{ t - - _r - f,► f <br /> Violation # 118 = Failure to submit the " Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> YJ This violation was correcteci El This violation will be corrected by (date) ; <br /> 13 Supporting documents int luded <br /> laescribe agtions taken or will be taken to correct violation_ <br /> r i r <br /> Page 2 sof 3 <br /> Iev. 8127W27019 <br /> 1a66 E , Hazelton Avenue I Stockton , California 95205E T 2TJ 468w34201 F 2�a 46441138 1 wwr ,§jmhd: co n <br />