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RECEIVED ON 10-03-2022 VIA EMAIL (3 OF 5) <br /> SAN,'JOAQUIN Environmental Health Department <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 /> SHORT STOP FOOD MART, 20 W TURNER RD #A, CERS IID: 10180633, PR0231380 <br /> Violation#115-Failure to submit"Monitoring System Certification Form"within 30 days of completion of the <br /> test. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included t <br /> Describe actions taken or will be taken to correct la ion: <br /> Violation#116-Failure to submit the"Spill Container Testing Report Form"within 30 days. <br /> 11!� 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: '{ zPI IrV11114's, Lk)1 1 <br /> WLon. L duuA I. I� <br /> l4 <br /> Violation#118-Failure to submit the"Overfill Prevention Equipment Inspection Report Form"within 30 days. <br /> dThis violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violatiop: P <br /> Rev.9116!2020 <br /> Page 3 of 5 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov,org/EHD <br />