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Environmental Health Department <br />Corrective Action Statement <br />RE: June 07, 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. <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 Vicky Vang-Lee at (209) 616-3028 or vvang-lee@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: VICKY VANG-LEE <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 #152 <br />10180631 <br />1721 S CHEROKEE LN # 1 <br />PR0519949 <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 #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 />X <br />HMBP training has been provided to employees. In the future employees will be provided initial and <br />annual refresher training and the training records will be kept in an onsite binder for the required <br />timeframe. Training records are attached. <br />The updated site map for Quik Stop-site #152 has been submitted into CERS and sent to site and EHD. <br />Future updates will be submitted within the required timeframe and will include all required content. <br />X <br />X