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SKJOAQUIN Environmental Health Department <br /> . � . <br /> —COU NTY- <br /> Greatness grows here. <br /> Corrective Action Statement <br /> RE: , inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. <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 at or . <br /> Facility name: Submit completed form to: <br /> Facility address: SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: none ATTN: <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> ❑ This violation was corrected ❑ This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Page 2 of 2 <br /> Rev.8/27/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />