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SANJOAH Environmental Health Department <br /> _. <br /> C N TY <br /> . <br /> .yp Fyfe F <br /> JJJ Corrective Action Statement <br /> RE: March 30, 2022, 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. <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 John Alaniz at(209)616-3053 or jalaniz1 @sjgov.org. <br /> Facility name: WATERLOO LIQUOR Submit completed form to: <br /> Facility address: 2512 E WATERLOO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181585 ATTN:JOHN ALANIZ <br /> PR0232418 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#105-Failure to have an approved UST Response Plan. <br /> Er 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: `✓,�a2� l�y� tJ' ,?�y� *a2 !�l-:,, <br /> _C� r Q L./c. v,—A Cly(sada�-4 <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <br /> M- 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: c( AAA,(j, t A C,,Yn z -tic4�-,. <br /> Rev.9/16/2020 Page 2 of 4 <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 />