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� 1If1 �AI Environmental Health Department <br /> 11 V N <br /> u _ <br /> r Greatness grows fere, <br /> Corrective Action Statement <br /> RE: July 11, 2024, inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will 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 /> Maria Lopez at(209)616-3064 or melopez@sjgov.org. <br /> Facility name: UNITED#5447 Submit completed form to: <br /> Facility address: 1469 E HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180781 ATTN: MARIA LOPEZ <br /> PR0231126 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#3-2010013-Facility has submitted a complete and accurate UST Monitoring Plan.. <br /> M This violation was corrected ❑This violation will be corrected by(date): 8-19-2024 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: monitor site map attached, uploaded to CERS, <br /> and copy will be put in the CUPA binder <br /> Violation#5-2030041 -A current facility plot plan is maintained and has been submitted. <br /> [R This violation was corrected ❑This violation will be corrected by(date): 8-19-2024 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: annotated map attached, uploaded to CERS, <br /> and copy will be put in the CUPA binder <br /> Violation#7-2010003-Owner/Operator submitted DO form and/or informed the CUPA of any change(s) <br /> within 30 days(TCR 10). <br /> IN This violation was corrected ❑This violation will be corrected by(date): 8-19-2024 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: DO ID form uploaded to CERS. <br /> Page 2 of 3 <br /> Rev.9/16/2020 <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 />