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RECEIVED ON 10-03-2022 VIA EMAIL (2 OF 5) <br /> SAWJOAQUIN Environmental Health Department <br /> CQUNTY---- <br /> GrtotAess grows ears. <br /> Corrective Action Statement <br /> RE: September 21, 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. <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 Gabriela Garcia-Mejia at(209)616-3037 or ggarcia-mejia@sjgov.org. <br /> Facility name: SHORT STOP FOOD MART Submit completed form to: <br /> Facility address: 20 W TURNER RD#A SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180633 ATTN: GABRIELA GARCIA-MEJIA <br /> PR0231380 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#102-Failure to submit a complete and accurate application for a permit to operate a UST. <br /> Q 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: \ y- jr\ ars <br /> Or5vv�(' AM <br /> 1" 1h<J' COI 1 <br /> Violation#104-Failure to submit a complete and accurate UST Monitoring Plan. <br /> MThis violation was corrected 11 This violation will be corrected by(date).- <br /> 0 <br /> date):❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violatT <br /> � ) 4 5 <br /> 2Llock's <br /> Violation 9107-Failure to submit and maintain complete and current financial responsibility documents. <br /> lel 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 yio tion: �� r�� <br /> � IC GU^ <br /> n C �4 � <br /> +r5 S <br /> Rev.9!1612020 Page 2 of 5 <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 />