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SANAAOUIN <br />—COUNTY <br />as griDoes <br />Environmental Health Department <br />RECEIVEu <br />:AY 0 1 2023 Corrective Action Statement <br />RE: April 03, 2023, Underground Storage Tank inspection relioct viRONNIENTAL HEALTH <br />For each violation listed below, indicate if the violation has been corrected or will be corrected by a ceRktOPiltP.SERVICES <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 Gabriela Garcia-Mejia at (209) 616-3037 or ggarcia-mejia@sjgov.org. <br />Facility name: NASHIR WATERLOO INC. <br />Facility address: 2358 E WATERLOO RD <br />CERS ID: 10182079 <br />PRO231756 <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: GABRIELA GARCIA-MEJIA <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #102 - Failure to submit a complete and accurate application for a permit to operate a UST. <br />1:11--1---his violation was corrected 0 This violation will be corrected by (date): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Nett, ocone.r.r <br />lip I rke-s 'It) XV/ <br />4 <br />ve"3 <br />Violation #107 - Failure to submit and maintain complete and current financial responsibility documents. <br />01-1s violation was corrected 0 This violation will be corrected by (date): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Ale-g-c) ct) 11 LL k inv4 11,44r- Ow n j4. Rep. A-vn <br />Violation #203 - Failure to maintain monitoring records for 36 months and maintenance records for 60 <br />months. <br />11K-fhis violation was corrected <br />Supporting documents included <br />0 This violation will be corrected by (date): <br /> <br />Describe actions taken or will be taken to correct violation: <br />d' C_ded /T-C; 36ft1&th4j ,Cer-r-e6f <br />Page 2 of 4 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 1 www.sjgov.org/EHD