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DocuSign Envelope ID:521A1594-1EDB-435F-B060-839FC1942BE8 <br /> EHD Received via email on: <br /> 7/28/2022 <br /> S A N J O A Q U I N Environmental Health Department <br /> COLJNTY— <br /> Greotneys qrows herr <br /> Corrective Action Statement <br /> RE: July 18, 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 Carol Presto at(209)616-3061 or cpresto@sjgov.org. <br /> Facility name: FedEx Ground-Tracy Submit completed form to: <br /> Facility address: 5655 Hood Way SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10689070 ATTN: CAROL PRESTO <br /> PR0540345 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <br /> N This violation was corrected ❑This violation will be corrected by(date): <br /> E�' Supporting documents included <br /> Describe actions taken or will be taken to correct violation: old forms were deleted from CERS,reloaded original forms <br /> advised can not use original forms,must use new updated forms.Entered new form into CERS <br /> Violation#110-Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> IV This violation was corrected ❑This violation will be corrected by(date): <br /> Id Supporting documents included <br /> Describe actions taken or will be taken to correct violation: old forms were deleted from CERS,reloaded original forms <br /> advised can not use original forms,must use new updated forms.Entered new form into CERS <br /> Page 2 of 4 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/EHD <br />