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SAN J O A Q U l N Environmental Health Department <br /> Corrective Action Statement <br /> RE: July 18, 2023, Underground Storage lank inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions,please contact <br /> Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: STKN ARMY AVIATION SU PP FACILITY* Submit completed form to: <br /> Facility address: 2000 STIMSON R❑ SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID 10181267 ATTN:VICKY YANG-LEE <br /> PR0231732 1868 E HAZELTON AVENUE <br /> STOCKTON. CA 95205 <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within30 days. <br /> Er//This violation was corrected 11 This violation will be corrected by(date): <br /> LSI Supporting documents included <br /> Describe actions taken or will be taken to correct violation: A rje".) ,.vis <br /> Cre,.k.'a C--alo. 64L 4,� +,.L CeAs. la, 10.0. Ter &uj)1rS I Sk.,A 0.1 Furw% w•4"1. rCr <br /> er�G 1,--► <br /> W1446go?, -ee 1 g <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving <br /> the report. <br /> W' 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: 11,15 k. orree lce SzP�wb+r <br /> %`'t Jm 22� A_rki- A-te .D gc. _r-L—ham. -rLv- Fw41.11 t.j-l1 ta^3,s.d -tee -17+4%)do <br /> .1.r <br /> Page2of3 <br /> Rev.9n&2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 ] www.sjgov.org/EHD <br />