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SA I O A Q I � I N Environmental Health Department <br /> .�ja� C 0 U <br /> 4 ICI <br /> .r Gircotnem Rro4w4 hrrr, <br /> Corrective Action Statement <br /> RE: April 02, 2026, inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Tori <br /> Okumura at()-or. <br /> Facility name: QUIK STOP MARKET#132 Submit completed form to: <br /> Facility address: 3555 W HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180893 ATTN: TORI OKUMURA <br /> PR0231130 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#1 -2011010-Facility obtained valid Permit to Operate from the UPA, complies with requirements <br /> and has paid fees. <br /> 0 This violation was corrected❑ ❑This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> UST Monitoring Plan and UST Response Plan have been sent to site to maintain onsite and have available for review. <br /> Violation#3-2011011 -Facility has submitted and maintains a complete and accurate UST Monitoring Plan. <br /> 0 This violation was corrected❑ ❑This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> UST Monitoring Plan has been updated and sent to site to maintain and have available for review. <br /> Violation#4-2011012-Facility has submitted and maintains a monitoring site plan. <br /> ❑ This 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 /> An enaineerina firm will be uodatina the Monitorina Site Plan to include scale and meet 2026 requirements. After completion, <br /> the updated plan will be submitted into CERS and sent to the site to maintain and have available for review. <br /> Page 2 of 3 <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 />