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SAN 10AQUIN Environmental Health Department <br /> CC%UN7 Y <br /> Corrective Action Statement <br /> RE: October 18, 2022, 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. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: H&S Energy Products,#3034 Submit completed form to: <br /> Facility address: 1434 W Yosemite Ave SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10169781 ATTN:PAUL NSO <br /> PR0231465 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#106-Failure to submit and maintain a current facility plot plan/site map. <br /> XThis 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: / / /(Rai � „�d04.%' <br /> «fie Ae �-4 <br /> Page 2 of 2 <br /> Rev.911612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />