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S A N J O A Q U I N Environmental Health Department <br /> C 0 U Wr�Y' <br /> Corrective Action Statement <br /> RE: January 22, 2025, 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 /> Lynsey Sammons at(209)616-3067 or Isammons@sjgov.org. <br /> Facility name: DINO MART Submit completed form to: <br /> Facility address: 1001 E YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180593 ATTN: LYNSEY SAMMONS <br /> PR0231876 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#2-2010010-Complete and accurate UST Operating Permit Application has been submitted.. <br /> 11 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#5-2030041 -A current facility plot plan is maintained and has been submitted. <br /> -f This violation was corrected ❑This violation will be corrected by(date): <br /> Supporting documents included J <br /> Describe actions taken or will be taken to rrect violation: �1 S <br /> Q U <br /> 7n <br /> Violation#10-2030074-Annual Monitoring System Certification Form to the CUPA within 30 days of <br /> completion of the test. <br /> * This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will bet ken to correct violation: <br /> Llkor-A' w <br /> � - <br /> jee� 1 <br /> Page 2 of 5 <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 />