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SAN J O A Q U I N Environmental Health Department <br /> N1 T <br /> Corrective Action Statement <br /> RE : January 14 , 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 stwoldearegay@sigov. org . <br /> Facility name: VALLEY PACIFIC HWY 99 CARDLOCK Submit completed form to: <br /> Facility address : 3550 S HWY 99 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10182167 ATTN : SHEWIT WOLDEAREGAY <br /> PR0505827 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #118 - Failure to submit the " Underground Storage Tank Statement of Understanding and <br /> Compliance Form" , <br /> X 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 : Statement is uploaded to CERS <br /> Violation #201 - Failure to maintain monitoring , maintenance, and follow up action records . <br /> X 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: Records are available on site <br /> Page 2 of 3 <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 />