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'c' SAKJ a An I I I Environmental Health Department �iL COUNTY Greatness grows here, Corrective Action Statement RE: October 25, 2019, Underground Storage Tank inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Paul Nso at (209) 468-3432 or pnsopsigov.orq. Facility name: ARMY COURT Submit completed form to: Facility address: 1624 ARMY CT SJC ENVIRONMENTAL HEALTH DEPARTMENT CERS ID: 10181409 ATTN: PAUL NSO PR0231014 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Violation #101 - Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees. ❑ This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: Violation #103 - Failure to submit and maintain complete and current financial responsibility documents. ❑ This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: Violation #104 - UST operating permit application for facility and tank information not submitted or current. ❑ This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: Page 2 of 6 Rev. 8/27/2019 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com