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S A N .10 A Q U I N Environmental Health Department <br />COLJNTY <br />Corrective Action Statement <br />RE: August 02, 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 Shewit Woldearegay at (209) 616-3063 or stwoldearegay@sjgov.org. <br />Facility name: <br />Facility address <br />;ERS ID: <br />QUIK STOP MARKET #138 <br />1153 LINCOLN BLVD <br />10181059 <br />PR0231413 <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: SHEWIT WOLDEAREGAY <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #206 -Failure to submit and have a current UST Response Plan readily available on site. <br />� This violation was corrected <br />❑ Support <br />ing documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />The UST Response Plan was sent to the site to maintain in their binder and will be readily available. <br />Violation #208 -Failure to comply with the designated operator inspection requirements. <br />CX <br />This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />For future designated operator inspection reports the designated operator will include all required <br />information according to the regulation. <br />Violation #306 -Failure to remove, analyze, and properly dispose of water in secondary containment (pre -Jul <br />2003). <br />� This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />Liquid was removed by Elite IV Contractors on 8/03/23. Belshire will be onsite by 8/25/23 to remove/ <br />replace the full drums. <br />Page 2 of 2 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />