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ANEnvironmental Health Department <br /> �Q�Q�� <br /> - _.._a.C Q U N T Y•---- <br /> Corrective Action Statement <br /> RE: June 29, 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. <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 Paul Nso at(209)468-3432 or pnso@sjgov.org. <br /> Facility name: VAN DE POL ENT INC/PACIFIC PRIDE Submit completed form to: <br /> Facility address: 351 N BECKMAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181401 ATTN: PAUL NSO <br /> PR0231310 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#121 -Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> O,--This violation was corrected ❑This violation will be corrected by(date): <br /> Er�_Supporting documents included <br /> Describe actions taken or will be taken to correct violation: CoWt A–-' TCI!q0111— <br /> Violation#202 -Failure to maintain the"Facility Employee Training Certificate" on-site (after October 1, <br /> 2018). <br /> P"'this violation was corrected ❑This violation will be corrected by(date): <br /> V--Supporting documents included <br /> Describe actions taken or will be taken to correct violation: n� i����. �°� <br /> Page 2 of 3 <br /> Rev.ar=2019 <br /> 1868 E, Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www,sjcehd.com <br />