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h"""• SAN,,JOAQUIN Environmental Health Department <br /> T . <br /> COL) NTY <br /> c' r C;reotness grows peri,. <br /> Corrective Action Statement <br /> RE: March 09, 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@sjgov.org. <br /> GEORGES BP MINI MART, 18662 N HWY 88, CERS ID: 10182137, PR0505356 <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): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#115- "Designated Underground Storage Tank Operator Identification Form" not submitted within <br /> 30 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 /> Violation#118- Failure to submit the "Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <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 /> Page 3 of 3 <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 />