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SAN JOAQUIN Environrinental Health Department <br /> Corrective Action Statennent <br /> RE: March OR 2020, Underground %Storage Tank inspection r port <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 /> FacHity name: GE:ORGES IBP (MINI MART Submil:completed form to: <br /> Facility address: 18662 N HVVY 88 SJC [-11,1VIRONMENTAL.HEALTH DEPARTMENT <br /> CER.S ID: 10182137 ATTN: I'AUL NSO <br /> PR0505356 1868 E:: HAZELTON AVENUE <br /> STO(',' TON, CA 9520 <br /> 'Violation#102- No written agreement between tank owner and tank operator to monfor the tank system. <br /> JKThis violation was corrected 1:1This violation will be corrected by(date)': <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> len VD <br /> Vio-latiion#103 -Failure to submit and maintain complete and current financial responsibility documents.. <br /> A This violation was corrected 0 This violation will be corrected by(dlate) _ <br /> ❑ Supporting documents included <br /> 0. <br /> Describe actions taken or will be taken to correct violation: 144- GAS ✓�,� <br /> LJDU_. <br /> Violation#105 -Failed to have an approved UST monitoring plan. <br /> 11WThis violation was corrected ❑I This violation will be couro•iacted by(date): <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: t� V�..,. 1 /11✓L W'u.S �� A <br /> �Jufzt awd fhcLQ hu, 4 It fl. I NL <br /> r �-1Ole <br /> _._..,_ <br /> +6k4ntin It7r <br /> Rev.8/27!2019 Page 2 of 3 <br /> 1868 E. Hazelton,Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />