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ECEIVEF <br /> SAN JO A Q U I NEnil o nmen Lrao Hoa l� h DapauL uenti <br /> SEP 0 � 2Q �.� <br /> 11SERVIHr_ AI <br /> Corrective Action Statement <br /> RE : July 30 , 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 Elianna Florido at ( 209) 616-3050 or eflorido@sjgov. org . <br /> Facility name : STKN ARMY AVIATION SUPP FACILITY* Submit completed form to : <br /> Facility address : 2000 STIMSON RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181267 ATTN : ELIANNA FLORIDO <br /> PR0231732 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #117 - Failed to submit "Secondary Containment Testing Report Form " within 30 days after the test. <br /> M 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 : TIlC oce e f y y., � ,� � i �+d /s. / C'N„�/, w cc ®f bcc <br /> wll �� "s,.. t fir ode-�1. rc ��sJ, :� , ad Ls✓� e� , � �e / of �ts � e2G?c .9�e Pa- <br /> Violation #122 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> fZr 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 : The sWee2:. {uoo� c... 1 ► fr5'twv �s <br /> cAe 6c An, 4a. Icy, cif be -5. 6 ,Yk cl ct � Ape <br /> 3 ® 5E al RZLWS CAS Aeo* A 4 4 re CwlrcAC <br /> d�► .Deny.. v� `^ 7�c ['a • ,( Z 07 " e%c/ . <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> 53 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 : //J� p/J gs� /, .o R,d •® / ;^ C1Ljde <br /> �i / / /� tl ✓ • CG �n s /w �� Rim 1 A, 1� q ,,..ed rCeo&2r !' I %gc liod ki, <br /> Page 2 of 3 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 I www. sjgov. org/EHD <br />