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SAN JOAQUIN Environmental Health Department <br /> Corrective Action Statement <br /> RE : August 15 , 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 : GAVINKO PETROLEUM * Submit completed form to : <br /> Facility address : 7700 MORELAND ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181359 ATTN : SHEWIT WOLDEAREGAY <br /> PR0231819 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 = Failure to submit and maintain complete and current financial responsibility documents . <br /> W446 This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> Describe ac 'ons taken or will be taken to correct violation : Q(` & +n ^� a <br /> 'o ar <br /> Violation #115 = Failure to submit " Monitoring System Certification Form " within 30 days of completion of the <br /> test. <br /> This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> t t <br /> Describe actions taken or will be taken to correct violation : <br /> Rev. 9/16/2020 Page 2 of 5 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www . sjgov . org/EHD <br />