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SAN MAOUIN <br /> Environmental Health Department <br /> Corrective Action Statement <br /> RE : October 22 , 2019 , Hazardous Materials 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 <br /> form with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please <br /> contact Paul Nso at (209) 468 -3432 or pnso@sjgov. org . <br /> Facility name : SHELL FOOD MART Submit completed form to : <br /> Facility address : 2320 N EL DORADO ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10182111 ATTN: PAUL NSO <br /> PR0519463 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #11 - Failed to provide or document initial and/or refresher training to appropriate personnel . <br /> t] 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 : <br /> 0 V1 <br /> RECEIEW <br /> NOV 0 4 2019 <br /> ENVIRONMENTAL HEALTH <br /> TISERV CES <br /> Page 2 of 2 <br /> Rev, 8/27/2019 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468- 3420 1 F 209 464 - 0138 1 www . sjcehd. com <br />