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SAN !O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE:August 13, 2019, 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 v olation 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 Shewit Woldesregay at(209)466-0216 or stwoldearegay@iygov org <br /> Submit completed form to <br /> Facility name- Lawrence Livermore National Lab Site 300 SJC ENVIRONMENTAL HEALTH <br /> Facility address 15999 W CORRAL HOLLOW RD DEPARTMENT <br /> CERS ID: 10154767 ATTN SHEWIT WOLDEAREGAY <br /> 1868 E HAZELTON AVENUE <br /> PR0231945 <br /> Violation#209•Failure to conduct the designated UST operator visual Inspection at least once every 30 <br /> days. <br /> This violation was corrected t7 This violation will be corrected by(date): <br /> C1 Supporting documents Included <br /> Describe actions taken or will be taken to correct violation <br /> Violation#309•Monitoring in sump!UDC failed to activate an audible and visual alarm or stop the flow <br /> product. <br /> This violation was corrected 13 This violation will be corrected by(data): <br /> 13 Supporting documents Included <br /> Describe actions taken or will be taken to correct violation LL DCA u Arlt . J C6NJ Oyti4' AA- brAf- 0� <br /> �t.ka lit �S WS 94Ct1% , 1- S}v <br /> Page 1 of 2 <br /> 1868 E Hazelton Avenue Stockton California 95205: T 209 468-3420, F 209 464-0138 1 www sioehd com <br />