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RECEIVED <br /> JUN 14 2024 <br /> ENVIRONMENTAL HEALTH <br /> SAN J O A Q U I N PERMIT/ SERVICE§ vironmental Health Department <br /> Corrective Action Statement <br /> RE : June 03 , 2024 , 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 Maria Lopez at (209) 616-3064 or MELOPEZ@SJGOV. ORG . <br /> Facility name : MY MINI MART Submit completed form to: <br /> Facility address : 1756 N WILSON WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10180819 ATTN : MARIA LOPEZ <br /> PR0231300 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #106 - Failure to submit and maintain a current facility plot plan / site map. <br /> This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included11LJ1 CiElKs <br /> __ <br /> Describe actions taken or will be taken to correct violation : rvt� � C( vLD� S ( iz� pok�VN " CC) vy ec C <br /> n <br /> Por.L i1^o rz . D, r- r,�-c\ I , - a La r a �,n7'C� ' n r` Ux & r" r) ru <br /> rte. % TCS 35o ci <br /> U b <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 /> VO <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> N1nyyk' L V%C � C'0 - .oL rxKd Let. Q_ v\ ou1_C rC-cOr <br /> Violation #208 - Failure to comply with the designated operator inspection requirements. <br /> 1° 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 /> cl�1lM -or) CY ]i .� � c�_ ,�ape,uyo <br /> Page 2 of 2 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www . sjgov . org/ EHD <br />