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SAN JOAQUIN <br />COUNTY <br />Environmental Health Department <br />Corrective Action Statement <br />RE November 15, 2023, Underground Storage Tank inspection report <br />For each violation listed below, indicate if the violation has been corrected or wit 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 />Stacy Rivera at (209) 616-3043 or srivera©sjgov.org. <br />Facility name: <br />Facility address: <br />CERS ID: <br />UNFI GROCERS DISTRIBUTION INC (STOCKTON) Submit completed form to <br />1990 N PICCOLI RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />10181455 <br /> ATTN. STACY RIVERA <br />PRO231820 <br /> 1868 E HAZELTON AVENUE <br />STDCKTON, CA 95205 <br />Violation #106 - Failure to submit and maintain a current facility plot plan site map. <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 Sensor for high flow sump (L3 SW) was not <br />marked with "x" on monitoring plan site map. Sensor has been marked on the site map and been <br />uploaded to CERS. <br />Violation #107 - Failure to submit and maintain complete and current financial responsibility documents. <br />This violation was corrected jbis violation will be corrected by (date): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: Line B in financial responsibility was not <br />filled out. Line B was filled out with the name of the operator "UNFI Grocers Distribution, Inc. (Stockton) <br />and has been uploaded to CERS. <br />Violation #110 - Failure to submit the "Underground Storage Tank Statement of Understanding and <br />Compliance Form". <br />This violation was corrected <br />Li Supporting documents included <br />his violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation, UST Statement of Understanding & Compliance <br />form was not included in most recent submission to CERS. UST Statement of Understanding & <br />Compliance has been signed, uploaded and submitted to CERS. <br />Page 2 of 3 <br />Rev 9/15/2020 <br />1868 E. HazeIton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov_org/EHD