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SHAUNEnvironmental Health Department <br /> ---CQUNTY­ <br /> Greotnest grows here <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@sjgov.org. <br /> Supervalu, 1990 N PICCOLI RD, CERS ID: 10181455, PR0231820 <br /> Violation #208 -Failure to comply with the designated operator inspection requirements. <br /> J? This violation was corrected Al This violation will be corrected by (date): i9K"-�°Z 9 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: ti/ l 6-11 Ce <br /> yl 5 t o r rn—a,.�s 4 i c/ eo J✓r e n I,eea t%r'w,c7.1'/' <br /> G< c(( !� <br /> —1-,Ile e <br /> tT�l d d/off n fc��l T.� �i <br /> J Cf �T�IIC�'l mrh 7 <br /> Violation #319 -Failure to comply with overfill prevention equipment requirements. <br /> �] This violation was corrected ❑ This violation will be corrected by(date): 3 --,2oa o <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: /fie�� a�T�� �K? 7r � <br /> Page 5 of 5 <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 />