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S A N-�,,NJ 0 A Q U I N Environmental Health Department <br /> 0o" COUNTY <br /> Gresctn�ss 5 <br /> Corrective Action Statement <br /> RE: July 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 Vicky Vang-Lee at(209)616-3028 or wang-lee@sjgov.org. <br /> BlackHawk Petroleum Inc., 56111 E WATERLOO RD, KERS ID: 10180881, PR0231764 <br /> Violation#1161-Failure to submit"Monitoring System Certification Form"within 30 day's of completion of the <br /> test. <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 /> �� �Com.. '�9�. �,�� •�--�'�-�- Q'��;1'T'..� . 7��� ��. �� S• -1 <br /> c� -kticY��P <br /> Violation#122 -Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> k2rThis 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 /> `—��, <br /> Violation#206-Failure to have current UST Monitoring Plan readily accessible at the facility. <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 correctt violation: <br /> Page:3 of 3 <br /> „onarzozowww.sjgov.org/EI-ID <br /> 1 RAR F HA70nn Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 <br />