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SAN 10 A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE : October 14 , 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 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 Shewlt Woldearegay at (209) 468-0216 or stwoldearegay@sjgov. org . <br /> Submit completed form toi <br /> Facility names COSTCO WHOLESALE #658 SJC ENVIRONMENTAL HEALTH <br /> Facility addressi 3250 W GRANT LINE RD DEPARTMENT <br /> CERS IDi 10146285 ATTNi SHEWIT WOLDEAREGAY <br /> 1868 E HAZELTON AVENUE <br /> PR0518288 <br /> Violation #109 - Failed to test secondary containment, or failed to maintain test records for 36 months . <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 vlolatloni <br /> Violation #306 - Monitoring equipment is not installed or maintained to detect a leak at the earliest <br /> opportunity . <br /> 0 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 vlolatloni �� , C.. .r v t. e. c� t s <br /> ` te Lf v <br /> i ' ; , C <br /> Page 1 of 2 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468 - 3420 1 F 209 464-0138 1 www. sjcehd com <br />