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r, SIN <br /> ANJ 0 AQ I I Environmental Health Department <br /> CDUNTY <br /> Greatness grows here. <br /> Corrective Action Statement <br /> RE: October 25, 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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: RAMOS OIL-FRENCH CAMP Submit completed form to: <br /> Facility address: 10842 S HARLAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182151 ATTN: KRISTINA SAETERN <br /> PR0505615 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> U This violation was corrected 13 This violation will be corrected by(date): <br /> 10/6/2021 <br /> $X Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Financial records have been updated in CERS <br /> kept onsite in a doghouse. <br /> Violation#110-Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> EX This violation was corrected [fix his violation will be corrected by(date): Nov 2 2021 <br /> ET Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Submitted in CERS <br /> maintained onsite in the doghouse <br /> Page 2 of 4 <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 />