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SAN J O A Q U I N Environmental Health Department <br /> Greatness prows hers:, <br /> Corrective Action Statement <br /> RE: June 22, 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 /> Stacy Rivera at(209)468-3440 or sriveraasigov.orq. <br /> Facility name: RANCHO SAN MIGUEL MARKET` Submit completed form to: <br /> Facility address: 1427 S AIRPORT WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184829 ATTN: STACY RIVERA <br /> PRO521942 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#121 -Failure to implement corrections and submit written response within 30 days of receiving <br /> the report. <br /> 0 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: Jesus Jurado Will make sure the written <br /> response and letter of correction is submitted before the 30 day limit. <br /> Violation#202-Failure to maintain the"Facility Employee Training Certificate"on-site(after October 1, <br /> 2018). <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: the training record was updated from <br /> Karen Arnaiz our D.O. will send a copy with the letter of correction. <br /> RECEIVED <br /> JUL 0 6 2021 <br /> ENVIRONMENTAL, IIEAI.rII <br /> 1)EP:kWFNIEN7' <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.coni <br />