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SAN O AQ I Environmental Health Department <br /> (� r ,' pt11C5f, t1 : i, <br /> Corrective Action Statement <br /> RE: November 13 , 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. <br /> Also , describe what was done to correct the violation in the space provided below each violation . Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection . If you have any questions , <br /> please contact Paul Nso at (209 ) 616 -3049 or pnso@sjgov . org . <br /> Facility name : TRACY MARKET INC Submit completed form to: <br /> Facility address : 15 E GRANT LINE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181019 ATTN : PAUL NSO <br /> 1868 E HAZELTON AVENUE <br /> PR0231404 STOCKTON , CA 95205 <br /> Violation # 107 - Failure to submit and maintain complete and current financial responsibility documents . <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 : <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> IK This violation was corrected [IThis violation will be corrected by ( date ) : <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation : 1 ►i P ,� (7 a � 6j �s , <br /> Li4S e > <br /> . � C . s. , <br /> •c <br /> Violation #210 - Failure to provide initial training , train every 12 months , and have a trained employee <br /> present . <br /> ❑ This violation was corrected ❑ This violation will be corrected by (date ) : <br /> 11 Supporting documents included <br /> Describe actio ns taken or will be taken to orrect violation : ' <br /> W of 71, ere, 1 C <br /> Page 2 of 2 <br /> Rev. 911612020 <br /> 1868 E . Hazelton Avenue i Stockton , California 952051 T 209 468 - 3420 1 F 209 464 -0138 1 www . sjgov . orglEHD <br />