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SKJOAQUIN Environmental Health Department <br /> 4 \�;; , -' CUUNTY------- <br /> ,, •.lw� Greotness grows here. <br /> Corrective Action Statement <br /> RE: January 31, 2023, 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: VAN DE POL ENTERPRISES INC Submit completed form to: <br /> Facility address: 816 E FRONTAGE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181513 ATTN: KRISTINA SAETERN <br /> PR0231470 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> IYThis 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 /> ha q r7v t {< bn--t ►6 <br /> a � <br /> Violation#203-Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months. <br /> Ea"'This violation was corrected ❑This violation will be corrected by(date): <br /> f-Supporting documents included <br /> Describe actions taken or will be taken to correct violation: /s <br /> �` 1't-a�-4�►e l <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> GY 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: <br /> W[ hA1I1 /'AicA ly-6.J <br /> l,hl. <br /> a nvc l's ` <br /> 4-S <br /> alot <br /> US <br /> aay.8/1612020 Page 2 of 2 <br />