Laserfiche WebLink
Environmental Health Department <br /> S . IN <br /> CO (JNTY <br /> Corrective Action Statement <br /> RE : June 21 , 2021 , 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 /> Elianna Florido at (209) 616-3050 or eflorido@sjgov. org . <br /> Facility name : RANCHO SAN MIGUEL MARKET" Submit completed form to: <br /> Facility address : 1427 S AIRPORT WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10184829 ATTN : ELIANNA FLORIDO <br /> PRO521942 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 - Failure to submit and maintain complete and current financial responsibility documents . <br /> [0 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 : A copy of the valid Insurance Policy for the <br /> Gas Station will be upload on CERS and will have a copy on site . <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> 12 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 : Jesus Jurado will Make sure all visual Inspections <br /> report documents are sign within the 48 hour time frame . <br /> Violation #307 - Failure to keep water out of the secondary containment system ( post-Jul 2003) . <br /> 0 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 : the water in the 91 sump was removed <br /> during the inspection and was placed in the 55 gallon barrels in back . will contact Service <br /> Station to replace the seals on the sump lids . <br /> Page 2 of 2 <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 />