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Environmental Health Department <br />Corrective Action Statement <br />RE: July 17, 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 />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: KRISTINA SAETERN <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 #550144 <br />10180967 <br />7272 WEST LN <br />PR0231939 <br />Violation #107 - Failure to submit and maintain complete and current financial responsibility documents. <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 #202 - Failure to retain a paper or electronic copy of the permit to operate 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 />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 />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 current financial responsibility documents <br />have been sent to the site and to the Inspector and will be maintained onsite available for review. <br />x <br /> The current permit to operate has been sent to the <br />site and to the Inspector and will be maintained onsite available for review. <br />x <br />The missing MSC and SCT documents have been sent to the site and to the Inspector and will be <br />maintained onsite available for review.