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S1If1 �AI Environmental Health Department <br /> -ry - <br /> 11 V N <br /> C U N T <br /> r Creotness grows fere, <br /> Corrective Action Statement <br /> RE: May 23, 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 /> Matthew Won at(209)616-3029 or mwon@sjgov.org. <br /> Facility name: MBM, Manteca Submit completed form to: <br /> Facility address: 800 MELLON AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181315 ATTN: MATTHEW WON <br /> PR0515468 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#3-4030038-SPCC has been implemented. <br /> Q 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: Corrected on site. Padlock is in place and locked <br /> at all times. Mangement will unlock during fuel delivery and lock after delivery insuring no spills took <br /> place. Key for lock is placed in key lock box in transportation office. <br /> Violation#57-4010021 -Written Inspection/testing procedures kept, inspection/testing records signed, kept <br /> for 3 years. <br /> q 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: Annual and monthly Inspection papers were <br /> placed in correct binder. This was corrected on site. <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 />