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AA ' 0aQ U I N Environmental Health Department <br /> kj <br /> - COUNTY <br /> ,� 'E_sr!`' h , [areUtFl � 5i Qr = , <br /> Corrective Action Statement <br /> RE : August 25 , 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 /> Vicky Vang- Lee at (209 ) 616-3028 or . <br /> MIRACLE MILE MARKET, 244 W HARDING WAY, CERS ID : 10180779 , PR0231137 <br /> Violation # 117 - Failed to submit "Secondary Containment Testing Report Form " within 30 days after the test. <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 # 1 8 - " Overfill Prevention Equipment Inspection Report Form " not submitted within 30 days of <br /> specti�on . <br /> k 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 /> % Vit, r� 3 Semis <br /> Violation #122 - Failure to implement corrections and submit written response within 30 days of receiving <br /> the report. <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 /> Page 3 of 4 <br /> Rev. 9/16/2020 <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 />