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SAN J OAQ U l N Environmental Health Department <br /> COUNTY <br /> Corrective Action Statement <br /> RE: November 13, 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 <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: Sutter Valley Hospitals dba Sutter Tracy Community F Submit completed form to: <br /> Facility address: 1420 N Tracy Blvd SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10397599 ATTN: PAUL NSO <br /> PR0231736 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 his violation will be corrected by(date): <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> �=�\ aa2L <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> EI This violation was corrected i his violation will be corrected by(date): <br /> T Supporting documents included <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 41 his violation will be corrected by(date): <br /> `Supporting documents included 11 <br /> Describe actions taken or will be taken to correct violation: 3'4L p <br /> --� <br /> Page 2 of 2 <br /> Rev.9116/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />