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S A N J 0 A Q U `i N Environmental Health Department <br /> , <br /> Corrective Action Statement <br /> RE: January 19, 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. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: VALLEY PACIFIC HWY 99 CARDLOCK Submit completed form to: <br /> Facility address: 3550 S HWY 99 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182167 ATTN: PAUL NSO <br /> PR0505827 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <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: <br /> n� CG:uA, <br /> Page 2 of 2 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton. California 95205 1 T 209 468-3420 F 209 464-0138 1 www sjgov org/EHD <br />