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A N// J Q U I N Environmental Health Department <br />Corrective Action Statement <br />RE: October 09, 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 />Haza Saeed at (209) 953-6212 or hsaeed@sjgov.org. <br />Facility name: BEAR CREEK WINERY Submit completed form to: <br />Facility address: 11900 N FURRY RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10183849 ATTN: HAZA SAEED <br />PR0520511 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #5 - 1010006 - Updated within 30 days of 100% increase or new haz; change of <br />address/owner/name; or change in ops. <br />❑ This violation was corrected This violation will be corrected by (date): 222u2 <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: we UQ A CA �P '� cy�CU) m i � � <br />Violation #11 -1010005 - Site Map with all required content electronically submitted. <br />❑ This violation was corrected This violation will be corrected by (date): Z %rJ2 <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: \NP, of to( I`-4M� nn Ui) An.1 <br />�i1, a <br />vim <br />Rev. 9/16/2020 Page 2 of 3 <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 />