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Environmental Health Department <br />Corrective Action Statement <br />RE: July 05, 2022, 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 Stacy Rivera at (209) 616-3043 or srivera@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: STACY RIVERA <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to:QUIK STOP MARKET #076 <br />10180695 <br />1030 S OLIVE AVE <br />PR0231704 <br />Violation #104 - Failure to submit a complete and accurate UST Monitoring Plan. <br />¨ 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 />Violation #203 - Failure to maintain monitoring records for 36 months and maintenance records for 60 <br />months. <br />¨ 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 />Violation #205 - Failure to submit and have current UST Monitoring Plan readily accessible at the facility. <br />¨ 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 />Page 2 of 3 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />x <br />The UST Monitoring Plans were corrected and submitted into CERS for review and approval. <br />x <br />The missing maintenance records have been located and provided to the site to maintain according to <br />the regulations. Future records will be maintained according to reulations. <br />x <br />The Monitoring Plans have been provided to the site and will be readily accessible in the future. <br />Copies attached.