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i <br /> I <br /> i <br /> a <br /> Environmental Health Department <br /> SAN JOAQUIN <br /> COU NTY4 <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@sjgov. org . <br /> Facility name: VALLEY PACIFIC LODI PLANT & CARDLOCK Submit completed form to: <br /> Facility address: 930 E VICTOR RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181885 ATTN : SHEWIT WOLDEAREGAY <br /> PR0502817 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 Uploaded to CERS <br /> Violation #121 - Failure to implement corrections and submit written response within 30 days of receiving <br /> the report. <br /> ❑ This violation was corrected X This violation will be corrected by (date) : <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : Statement is hereby submitted . 30 day response time <br /> will be met in the future <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 />