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S A WJ 0 A QU I N Environmental Health Department <br /> AVCOUNTY <br /> Corrective Action Statement <br /> RE : August 18 , 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 form <br /> with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please contact <br /> Shewit Woldeareqay at (209) 468-0216 or stwoldearegaypsigov. orq . <br /> Facility name : Verizon Business : KINGCA Submit completed form to : <br /> Facility address : 13850 N DE VRIES RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181479 ATTN : SHEWIT WOLDEAREGAY <br /> PR0231547 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #205 - Failure to submit a current UST Response Plan and have it available onsite. <br /> In 'This violation was corrected ' ` This- violation will be corrected by (date) : j <br /> ❑ Supporting documents included s <br /> � r <br /> Describe actions taken or will It orre a takect violation : vv�e 0i, <br /> 140 112(A& ezI <br /> AOFJ <br /> Violation #209 - Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days . <br /> i <br /> . . . 0 This violation was corrected ti,[Jl This violation will be corrected by (date) : <br /> i <br /> ❑ Supporting documents included <br /> n <br /> Describe actions taken or will be take to correct violation : G 7 <br /> r J <br /> Page 2 of 2 <br /> Rev. 812712019 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 T 209 468-3420 F 209 464- 0 '138 1 www , sjcelid . coni <br />