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' D <br /> RE <br /> SANS OAQUI <br /> OCl 7 vir n ental altDepartment <br /> FNVIRO P MN <br /> 0. <br /> Corrective Action Statement <br /> RE : September 29 , 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. <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 ) 616-3049 or pnso@sjgov . org . <br /> Facility name : WEST LANE CHEVRON Submit completed form to: <br /> Facility address : 4747 WEST LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181343 ATTN: PAUL NSO <br /> PR0232482 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #209 - Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days . / <br /> W This violation was corrected ❑ This violation will be corrected by ( date) : �� E' �4pe� be"I <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : 1 U�e4v � /`l/ 1/ 3z Ice /S j <br /> Z<9aree� � e en 721a. eG,N,- .,2 ; A a2e') . 72 s5g1. ® v/ he:G f267 X� Lan� r <br /> l 'r fn f' rrcr j3a= JI A^ <br /> Page 2 of 2 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue ( Stockton , California 95205 T 209 468-3420 1 F 209 464 -0138 1 www . sjgov . org/ EHD <br />