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SAN J O A Q U l N Environmental Health Department <br /> C OUNTY <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 farm 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 /> San Joaquin General Hospital, 500 W Hospital Rd, CERS ID: 10643278, PR0231614 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <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 the <br /> revised financial responsibiltiy certification form <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> fl report. <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: Please see attached <br /> Violation#202-Failure to retain a paper or electronic copy of the permit to operate at the facility. <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: Applying for permit <br /> Page 3 of 4 <br /> Rev.311612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/EHD <br />