Laserfiche WebLink
SAN J0AQUI N Environmental Health Department <br />COUNTY <br />Corrective Action Statement <br />RE: October 27, 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 />QUICKI KLEEPI CAR WASH, 707 E YOSEMITE AVE, CERS ID: 10182307, PR0505151 <br />Violation #109 -Failure to submit "Designated Underground Storage Tank Operator Identification Form" <br />within 30 days. <br />q This violation was corrected <br />® Supporting documents <br />included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will betaken to correct violation: <br />Violation #110 -Failure to submit the "Underground Storage Tank Statement of Understanding and <br />Compliance Form". <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: 1�Jtw �11t�� <br />Violation #116 -Failure to submit "Monitoring System Certification Form" within 30 days of completion of the <br />test. <br />❑ This violation was corrected <br />❑ Supporting documents included <br />q <br />Rev. 9!16!2020 <br />IThis violation will be corrected by (date) <br />Describe actions taken or will be taken to correct violation: <br />Page 3 of 5 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />