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SAN J OA Q O I N Environmental Health Department <br /> T <br /> Corrective Action Statement <br /> RE : February 03 , 2020 , 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 . 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 <br /> Shewit Woldearegay at (209) 468-0216 or stwoIdearegay@sjgov. org . <br /> Facility name : E F KLUDT & SONS INC Submit completed form to : <br /> Facility address : 1126 E PINE ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181397 ATTN : SHEWIT WOLDEAREGAY <br /> PR0231364 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #209 - Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days . <br /> This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included �� nn <br /> Des ribe actions taken or will be taken to correct violation : W,40� (AJ j YI ,MakP SU ISP 110V IY14 <br /> Ir be OpAnrmec <br /> -3 U' i i b 92 Lr 16a � (20 (1 <br /> Page 2 of 2 <br /> Rev. 8/27/2019 <br /> 1868 E . Hazelton Avenue I Stockton , California 952051 T 209 468-3420 1 F 209 464-0138 1 www. sjcehd . com <br />