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Received 5/7/2023 S A N J a A Q U I N Environmental Health Department 'COUNTY Grcotneii grows htrc,. Corrective Action Statement RE: April 25, 2023, Underground Storage Tank inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Shewit Woldearegay at(209)616-3063 or stwoldearegay@sjgov.org. Facility name: JD Service Station, Inc. Submit completed form to: Facility address: 9015 WALNUT GROVE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT CERS ID: 10443520 ATTN: SHEWIT WOLDEAREGAY PR0521738 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Violation#107-Failure to submit and maintain complete and current financial responsibility documents. ❑✓ This violation was corrected ❑This violation will be corrected by(date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: Uploaded to CERS Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the report. 0 This violation was corrected ❑This violation will be corrected by(date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: All Documents have been Submitted Violation#208-Failure to comply with the designated operator inspection requirements. 0 This violation was corrected ❑This violation will be corrected by(date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: All future inspections will be performed no more than 30 days Page 2 of 3 Rev.9/16/2020 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD