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SAN �� IIIN Environmental Health Department <br /> -COUNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: August 31, 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 Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: STOP N SHOP Submit completed form to: <br /> Facility address: 1856 W COUNTRY CLUB BLVD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180831 ATTN:VICKY VANG-LEE <br /> PR0231069 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#101 -Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees. <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 violation: <br /> Violation#102-UST operating permit application for facility and tank information not submitted or current. <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 violation: <br /> Violation#105-Failed to have an approved UST response plan. <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 violation: <br /> Page 2 of 7 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />