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Environmental Health Department <br />Corrective Action Statement <br />RE: June 02, 2021, 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 Carol Presto at (209) 616-3061 or cpresto@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: CAROL PRESTO <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to:QUIK STOP MARKET #125 <br />10180643 <br />1580 W MAIN ST <br />PR0519799 <br />Violation #6 - Failed to electronically submit a site map with all required content. <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 #9 - Failed to annually review and certify that the HMBP is complete and accurate by the due date. <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 #11 - Failed to provide or document initial and/or refresher training to appropriate personnel. <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 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />X <br />The HMBP will be submitted annually by the required due date. <br />X <br />Site map has been updated and submitted into CERS and is attached. Future maps will include required <br />content. <br />x <br />x <br />HMBP training has been conducted and in the future will be conducted and documented within the <br />required timeframe. HMBP training record is attached. <br />X