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S ����O I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: February 07, 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. Sub it 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: WILSON WAY CHEVRON Submit completed form to: <br /> Facility address: 437 N WILSON WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180899 ATTN:GABRIELA GARCI -MEJIA <br /> PR0506406 1868 E HXZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> 4 This violation was corrected J�ihis violation will be corrected by(date): / 2- <br /> 13 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: 2% <br /> O. <br /> 2-._ Z/'Zt <br /> /✓r►eL� tt� /rr <br /> Rev.9/16/2020 Page 2 of 2 <br /> 1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 isjgov.org/EHD <br />