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SAN 10AH I N Environmental Health Department <br /> c:. AUNTY <br /> Corrective Action Statement <br /> RE : May 08 , 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 Paul Nso at ( 209 ) 616 -3049 or pnso@sjgov . org . <br /> Facility name : SINCLAIR NORTH MAIN Submit completed form to : <br /> Facility address : 1245 N MAIN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10842520 ATTN : PAUL NSO <br /> PR0541906 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #101 - Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees . <br /> Q3/ This violation was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included <br /> Describe actions aken or will be taken to correct violation : � <br /> Y �� C k A!?,1CYY1 J V <br /> Violation #102 - Failure to submit a complete and accurate application for a permit to operate a UST . <br /> M This violation was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included <br /> Describe actions taken or will taken to cor ct violation : <br /> Viol= olation <br /> - Failure to submit a complete and accurate UST Monitoring Plan . <br /> was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included <br /> Describe actions taken or ill be taken to correct vlation : V Zj <br /> Page 2 of 5 <br /> Rev, 9/16/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 952051 T 209 468 -3420 1 F 209 464 -0138 1 www . sjgov . org / EHD <br />