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SAN JOAQUIN Environmental Health Department <br /> COUNIY <br /> Corrective Action Statement <br /> RE:January 24, 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 Shewit Woldearegay at(209)616-3063 or stwoldearegay@sjgov.org. <br /> Facility name: TRACY SHELL Submit completed form to: <br /> Facility address: 3725 N TRACY BLVD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181411 ATTN:SHEWITWOLDEAREGAY <br /> PR0231417 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#101 -Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees. <br /> IV 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: Permit fees have been Submitted. <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <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: In the future,designated operator nofification will <br /> be submitted within 30 days. <br /> Page 2 of 6 <br /> Rev 9/16 <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 />