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Parkwood Gas & Food 2098888157 p . 2 <br /> S A N J 0 A Q U I N Environmental Health Depa riment <br /> Corrective Action Statement <br /> RE : May 18 , 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 John Alaniz at (209) 616 -3053 or jalanizl @sjgov .org . <br /> Facility name : PARKWOODS GAS & FOOD Submit completed form to: <br /> Facility address : 1612 W HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181241 ATTN : JOHN ALANIZ <br /> PR0231127 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #104 - Failure to have an approved UST Monitoring Plan. <br /> ❑ This violation was corrected L'7 This violation will be corrected by (date) : ( 4 2 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : 6e, S L1 l Y -e Ma. kLm, <br /> Violation #203 - Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months. <br /> ❑ This violation was corrected 11 This violation will be corrected by (date) : <br /> V' Supporting documents included <br /> Descdbe actions taken or will be taken to correct violation : 10CC&PAOC �--� W " ;; ' Le% yrCA�j <br /> o,^ J W f h� � e/r+ClV'rVi 4ol . % o% W � � AA U <br /> Violation #205 • Failure to have current UST Monitoring Plan readily accessible at the facility. <br /> 091�0 This violation was corrected ❑ This violation will be corrected by (date) : m, <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation :AAh �t/ si '�--�- mb ✓! ( 'Y1 �th � _„ �_ <br /> loco� <br /> MLI Row <br /> Page 2 of 3 <br /> ate.. sr� sraoso <br /> Received Time � J a n . $ , w20211 10 : 1 OAM '-No , 6 ] ( 135205 1 T 209 468-3420 1 F 209464-0138 1 wu1iv . sjg0v . or9lEH1 ' <br />