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SAN J 0 A Q U I N Environmental Health Department <br /> { > <br /> 3 ' J 1�j f ,{ RECEIVED <br /> Corrective Action Statement NOV 1 ;0: 8 2021 <br /> RE : April 21 , 2021 , Underground Storage Tank inspection report <br /> nn � nI <br /> For each violation listed below , indicate if the violation has been corrected or will be corRWINNN' �li �latte, TEALTH <br /> Also , describe what was done to correct the violation in the space provided below each violation iRA fITM <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 /> TOKAY SHELL , 420 W KETTLEMAN LN # 1 , CERS ID : 10767814 , PRO544259 <br /> Violation # 122 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report , <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 /> TDe <br /> r P <br /> Violation #205 - Failure to have current UST Monitoring Plan readily accessible at the facility . <br /> its violation was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to co ect violatio <br /> : 4 N <br /> *Z Ale <br /> /) <br /> Cie ay <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <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 /> G /7"' { l <br /> A tip <br /> ill <br /> �t w' ► rtd O1 .k) rVr4h <br /> Page 4 of 5 <br /> Rev . 9/ 16/2020 <br /> 1868 E . Hazelton Avenue ( Stockton , California 95205 1 T 209 468- 3420 1 F 209 464 -0138 1 wvvw . sjgov . org/EkID <br />