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�s <br /> ,r r'► <br /> S A N!J Q Q Q U I N Environmental Health Department <br /> COUNi �{._.. <br /> Grtatn#ss grows h#re. <br /> Corrective Action Statement <br /> RE: June 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. 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 Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: VAN DE POL ENT INC/PACIFIC PRIDE Submit completed form to: <br /> Facility address: 351 N BECKMAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181401 ATTN: PAUL NSO <br /> PR0231310 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#202-Failure to retain a paper or electronic copy of the permit to operate at the facility. <br /> his 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: vrui,it `p(fAc P)LOLve4ya <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> 64' 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: �)f INAUF "c n lh jc a Ck,. VVA..1 TyiN .c. <br /> ti <br /> hIP S,2.✓1 rVA 'WL N D i nSJ]rL" U APL-kC a IILL oft .h lC'WX S1 ✓i t�L�: S <br /> qN AA Ca^^ exaSwylz a-eh rlp "'1Ghld Oh T'yhe• <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 />