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SAN O AUINEnvironmental Wealth Department <br /> COUNTY <br /> G , wyclrrr � ss � � � 11f3re , <br /> Corrective Action Statement <br /> RE : January 07, 2021 , 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 : JOES TRAVEL PLAZA Submit completed form to: <br /> Facility address : 15600 S HARLAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10180541 ATTN: PAUL NSO <br /> PR0231585 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #118 - Failure to submit the "Overfill Prevention Equipment Inspection Report Form" within 30 days , <br /> This violation was corrected 0 This violation will be corrected by (date ) : <br /> K Supporting documents included ft <br /> Describe actions taken or will be taken to correct violation: <br /> S {�wwes� I S ec n G0 <br /> G d 0 ,V" e/ a TIL <br /> tam tv C � CRW `1D�1 � kA ' <br /> C TobJ+ (/ to <br /> - etl i� ►' �I� We alk VUi4 <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> G! This violation was corrected 0 This violation will be corrected by (date) : <br /> 0 Supporting documents included <br /> Describe actions taken or will be to en to correct violation : �-- W <br /> �,�• � t\W ` ' <br /> ins a 6Avac I � ° <br /> CD � I X �-- 0 I �' <br /> dO C 1 <br /> 4/01 <br /> k� <br /> '° <br /> V <br /> Page 2 of 2 aA <br /> Rev. 9116/2020 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468-3420 1 F 209 464 -0138 1 www. sjgov. org/EHD <br />