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SAN J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Greotness grow5 <br /> Corrective Action Statement <br /> RE: August 25, 2023, 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 Vicky Vang-Lee at(209)616-3028 or vvang-lee@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:VICKY VANG-LEE <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 ®This violation will be corrected by(date): August 31, 2023 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Site will apply and pay for an operating permit <br /> F <br /> Violation#102-Failure to submit a complete and accurate application for a permit to operate a UST. <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: Applied and paid for permit. EHD will issue upon completed <br /> repairs. <br /> Violation#104-Failure to submit a complete and accurate UST Monitoring Plan. <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: On August 25, 2023 CERS was updated with <br /> the correct annular sensor model and continuous monitoring for piping was changed to yes with Pneumercator as the <br /> manufacturer <br /> Page 2 of 4 <br /> Rev.9116/2020 <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 />