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Will <br /> Environ ental Health Departent <br /> SA. N JOAQUINC. C) tj N -461 y <br /> f <br /> A <br /> Corrective fiction Statement <br /> RE -. April 1 ? , 2024 , Underground Storage Tank inspection report <br /> For each violation listed below , Indicate if the violation has been collected 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 Varig-Lee at (209) 616-3028 or vvarig-!ee@sjgay. org . <br /> Facility name : WOODBRIDGE GAS , MARKET & LIQUOR Submit completed farm to: <br />� Facility address: 18806 N LOWER SACRAMENTO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> i <br />' CERS ID 's 10181237 ATTN -. VICKY YANG-LEE <br />� 1868 E HAZELTON AVENUE <br /> PR0232388 <br /> 10 <br /> STOCKTON , CA 95205 <br /> Violation #109 - Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees. <br /> . This violation was corrected ❑ This violation will be corrected by (date) : <br /> El Supporting documents included <br /> f <br /> Describe actions taken or wil be taken to correct violations <br /> or <br /> )PIL <br /> 49 <br /> Violation #'iO4 - Failure to submit a complete and accurate UST Monitoring Plan. <br /> KOOOOTThis violation was corrected 11 This violation will 6e corrected by (date) ; ohs <br /> ❑ Supporting documents included <br /> Describe actions taken or will be tauten to correct violation ; � ���Ve <br /> .1 r)i 6 .9 <br /> Violation #107 - Failure to submit and maintain complete and current financial respvEisibility documents. <br /> This violation was corrected ❑ This violation will be corrected by (date) : <br /> C] Supporting documents included <br /> Describe actions taken or will be taken to correct violation ; <br /> 005tij typo-- CH A4L <br /> Page 2 of 5 <br /> RQv, 9116i2020 <br /> 1868 E . 11azellon Avenue I Stockton , Californi'a 952051 T 209 468-34201 F 209 4b4-0138 www.sjgov.orgJEHD <br />