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S A N.J 0 AQ U I N Environmental Health Department <br /> COUNTY <br /> Grrotnri grows herr. <br /> Corrective Action Statement <br /> RE: August 19, 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 Frederick Ernest at(209)616-3026 or fernest@sjgov.org. <br /> Facility name: San Joaquin General Hospital Submit completed form to: <br /> Facility address: 500 W Hospital Rd SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10643278 ATTN: FREDERICK ERNEST <br /> PR0231614 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#101 -Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees. <br /> ❑ This violation was corrected [3This violation will be corrected by(date): as soon as the leak <br /> ❑ Supporting documents included detector Es installed <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#202-Failure to retain a paper or electronic copy of the permit to operate at the facility. <br /> ❑ This violation was corrected t3l This violation will be corrected by(date): as soon as leak detector is installed <br /> ❑ Supporting documents included EHD will issue permit <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <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: Designated Operator Inspection Reports have been updated. <br /> Page 2 of 3 <br /> Rev.911612020 <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 />