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SAN JOAQUIN <br /> <br />Environmental Health Department <br />—COUNTY <br />Greatness grows her <br />Corrective Action Statement <br />RE: November 19, 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 <br />form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br />contact Paul Nso at (209) 616-3049 or pnso@sjgoy.org. <br />Supervalu, 1990 N PICCOLI RD, CERS ID: 10181455, PRO231820 <br />Violation #122 - Failure to implement corrections and submit written response within 30 days of receiving the <br />report. <br />Et This violation was corrected laThis violation will be corrected by (date): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: g;:i (.0i'vec77t‘0 .1..1 507 47 Jarkv -r <br />e J/74.9 re 41. c 7", km ety <br />Violation #202 - Failure to retain a paper or electronic copy of the permit to operate at the facility. <br />p This violation was corrected lJ This violation will be corrected by (date): //—/ 2 c7,0 <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: .7.ki w in es 4 <br />`6 c -1/ e c/sec r d <br />u4, 777 ,,11 _f ny, 7' ely r/Ol " erf <br />Violation #205 - Failure to have current UST Monitoring Plan readily accessible at the facility. <br />4 ci"ivol Lij <br />(13/ This violation was corrected EiThis violation will be corrected by (date): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />/11 <br />/ —/ Y <br />/ IC di eif 7;r ( e <br />Page 4 of 5 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 I F 209 464-0138 I www.sjgov.org/EHD