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SAN , J O A Q U I N Environmental Health Department <br /> Tv <br /> Corrective Action Statement <br /> RE: February 10, 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 sriveraO-sjgov.orq. <br /> Facility name: AT&T California-UE020 Submit completed form to: <br /> Facility address: 124 W Elm St SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10207012 ATTN:STACY RIVERA <br /> PR0231866 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#209-Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days <br /> 19' This violation was corrected 0 This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Rev-812712019 Page 2 of 2 <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />