Laserfiche WebLink
Environmental Health Department <br /> QA N sd OAQU I NCOUNTY— <br /> qrows stere, <br /> Corrective Action Statement <br /> RE: August 08, 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: EI Dorado Food Mart Submit completed form to: <br /> Facility address: 1901 S EL DORADO ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180839 ATTN:VICKY VANG-LEE <br /> PR0231092 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> `7i <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 /> CX <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> *1 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 /> OCA <br /> Page 2 of 3 <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 />