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Environmental Health Department <br />Corrective Action Statement <br />RE: July 17, 2023, Hazardous Materials 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 Michael Suszycki at (209) 598-7001 or msuszycki@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: MICHAEL SUSZYCKI <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to:7-ELEVEN INC. #41342 <br />10898140 <br />1233 E DR MARTIN LUTHER KING JR BLVD <br />PR0547069 <br />Violation #6 - Failed to electronically submit a site map with all required content. <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 />Violation #7 - Failed to electronically submit an adequate ER procedures for a release or threatened release. <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 />Violation #11 - Failed to provide or document initial and/or refresher training to appropriate personnel. <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 />Page 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />x <br />Site map updated per requests and submitted in CERS on 8/10/23. <br />x <br />ER plan updated and submitted in CERS on 8/10/23. <br />x <br />x <br />Confirmed with operations team that Sara no longer works at this store. Current DO training roster <br />attached.