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Environmental Health Department <br /> SANaAQUINCOUNTY <br /> Grectne3s groves hc- re. <br /> Corrective Action Statement <br /> RE : August 24 , 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 <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 : CRUISERS MANTECA #29 Submit completed form to: <br /> Facility address : 1137 W LATHROP RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10187387 ATTN: PAUL NSO <br /> PR0530093 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #106 - Failed to have an approved UST response plan . <br /> ® This violation was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included I <br /> Describe actions taken or will be taken to correct violation : <br /> 0(� 0� tzc� ;U 0 M � <br /> Violation #121 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report . <br /> a 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 : 'Z1ni. C.rjr Ce c . QA Vbr 44oc� <br /> te( 0 G �,� <, ,r - x -e ue tEr re, <br /> Violation #319 - No spill bucket, failed to contain 5 gallons , no means to keep it empty, or failed to be tested . <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 : 3 ) (Z � n 111 _ 11 )cam <br /> Page 2of2 <br /> Rev, 8/18/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www , sjgov . org/EHD <br />