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Parkwood Gas & Food 2098888157 p . 3 <br /> SAN 10 A Q U I N Environmental Health Department <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 orjalanizl @sjgov . org . <br /> PARKWOODS GAS & FOOD , 1612 W HAMMER LN , CERS ID : 10181241 , PR0231127 <br /> Violation #214 - Failure to comply with UST operating permit conditions . <br /> ❑ This violation was corrected ❑ This violation will be corrected by (date) : <br /> 9^ Supporting documents included � <br /> Describe actions taken or will be taken to correct violation ; 4- �l�u/L °� t1,1 t � "a�, <br /> ': <br /> 5 + <br /> t. �W4 _ we C) EI k ( V , c yon k6W Ck.0 tj <br /> fed 14 Ns�z Vo n Ca.r C ^ 4�e {M L 4 ec <br /> 20 0t -- S � 5 - � 5�7 <br /> Violation #304 - Failure to construct, operate , and maintain primary containment as product-tight <br /> [3This violation was corrected 13 This violation will be corrected by ( date) : <br /> ❑ Supporting documents included 1 <br /> Describe actions taken or will be taken to correct violation ; �1A o CO (Y) d b ILP <br /> +0 +TL ( tt COA 1 cfj I. w 4 I Y12ed day �.r4opj e 4j'e p vv%kov` i� Iwo 1XI14 <br /> uoc- � I �- W 1 ( 1 6 122 „ ti, -✓ kms .. ,_ l . � -�- <br /> � T <br /> Page 3 of 3 <br /> Rev. 9116/2020 <br /> Received Time IJ u n , $ . ' 2021 1 0 ; 1 OAM �No , 616115205 i T 2D94(38-34201 F 209464-0138 1 www. sjgov . org/ENC <br />