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5 <br /> SAN-JOAQUIN <br /> Environmental Health Department <br /> COUNTY <br /> reeltn g grow <br /> Corrective Action Statement <br /> RE: September 22, 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: KPMC MANAGEMENT INC, DBA:ARCO CHEROKEI Submit completed form to: <br /> Facility address: 900 S CHEROKEE LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180627 ATTN: PAUL NSO <br /> PR0231841 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#104-Failure to submit a complete and accurate UST Monitoring Plan. <br /> NThis 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 /> AR 1 o K� <N <br /> t <br /> '9 <br /> Violation#115-Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> VThis 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: u <br /> S'L;ify? 4j,-< -ICA T /)Qry A W <br /> a a <br /> Violation#202-Failure to retain a paper or electronic copy of the permit.to operate 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 correct violation: �' �, /nelke <br /> --tio s <br /> Page 2 of 3 <br /> Rev.9/16/2020 <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 />