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SANJOAQUIN <br /> Environmental Health Department <br /> U raj Y <br /> Corrective Action Statement <br /> RE : December 06 , 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 Elianna Florido at (209) 616-3050 or eflorido@sjgov. org . <br /> Facility name : FOOD 4 LESS FUEL CENTER* Submit completed form to : <br /> Facility address : 3408 MANTHEY RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10184365 ATTN : ELIANNA FLORIDO <br /> PRO521660 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <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 : Jesus Jurado will make sure all submittals on <br /> ( CERS ) all elements will be be reviewed and submitted before January 15th due date . <br /> Page 2 of 2 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue ( Stockton , California 95205 T 209 468-3420 1 F 209 464-0138 1 www. sjgov.org/EHD <br />