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O AQU f Environmental Health Department <br /> COLs 'tirY I <br /> Corrective Action Statement <br /> RE: July 11, 2022, 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 form <br /> with the Return to Compliance Certification within 30 days of inspection. if you have any questions, please contact <br /> Nicholas Loehrer at(209)468-0623 or nloehrer@sjgov.org. <br /> Facility name: JIFFY LUBE 93808 Submit completed form to: <br /> Facility address. 3276 GRANT LINE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10773058 ATTN: NICHOLAS LOEHRER <br /> PRO543826 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 /> P' This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included ( t1 <br /> Describe actions taken or will be taken to correct violation: c �P o A 1 t✓D d� f LZ,D 122 <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 />