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SAN J O A Q U I N Environmental Health Department <br /> C_: C U i•j F Y <br /> Gr - <br /> Corrective Action Statement <br /> RE : September 11 , 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 Shewit Woldearegay at (209) 616=3063 or stwoldearegay@sjgov.org . <br /> Facility name : ST JOSEPHS HOSPITAL Submit completed form to : <br /> Facility address : 1800 N CALIFORNIA ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181391 ATTN : SHEWIT WOLDEAREGAY <br /> PR0231036 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #208 = Failure to comply with the designated operator inspection requirements . <br /> � <br /> ❑ This violation was corrected 04his violation will be corrected by (date) : <br /> m/Supporting documents included l ,�. <br /> Describe actions taken or will be taken to correct violation : y c z r otL A op J/ TT, a fVA f' <br /> qr,, ��' Nn�' df� �0 �Y�A � To U4ru4 K(JYL �ibC,U (`1(��J1'r D ,J <br /> Page 2 of 2 <br /> Rev, 911612020 <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 />