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SAN J O A Q U I N Environmental Health Department <br /> CCUi�! i1' <br /> r <br /> Corrective Action Statement <br /> RE: September 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 Gabriela Garcia-Mejia at(209)616-3037 or ggarcia-mejia@sjgov.org. <br /> Facility name: ST JOSEPHS HOSPITAL Submit completed form to: <br /> Facility address: 1800 N CALIFORNIA ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181391 ATTN: GABRIELA GARCIA-MEJIA <br /> PR0231036 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation 9208-Failure to comply with the designated operator inspection requirements. ,/ <br /> ❑ This violation was corrected 0 his violation will be corrected by(date): �jv �l ��.,�,�tmoywb <br /> ❑ Supporting documents included ,� "" /40atjok�Vf <br /> Describe actions taken or will be taken to correct violation: c__/[�/1 p r`04UT AV S HF-E- " <br /> G.s1rA :rN(5 MWeMun R-;MUkREJ tr*69j-1ATKzd /+l H 01600 <br /> So All 44ny(� R Go->0 (Z F'tLtWDe Koji, <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 />