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001 <br /> Environmental Health Department <br /> SAN JOAQUIN <br /> CorrectiveAction Statement <br /> F Ma r h 0 1 2 0 2 5 I n n l n report <br /> For each violation listed below., indicate if Iiofataon has been corrected or mill be corrected by a cerlain date Also. <br /> describe what was done to correct the violation in the space provided below each violalron Submit this completed form <br /> % ith the Return to Compliance Certification within 30 days of inspection If you have any questions. please contact � <br /> r <br /> Allen Asio at 0 1 - 0 1 or llen asio ov or � <br /> COUNTRY MARKETPLACE , 1789 W CHARTER WAY, CERS 1D : 10182247, PR0506538 <br /> Violation #10 - 2030074 - Annual Monitoring System Certification Form to the CUPA within 30 stays of <br /> completion tion of the test., <br /> This violation was corrected El This violation will be corractod b (date): <br /> 11 Supporting documents included <br /> Describe actions taken or will be taken to correct violation <br /> 67-�� <br /> Violation #1 - 2010009 - Secondary containment test results submitted to tho CUPA within 30 days after the <br /> task.. <br /> This violation was corrected El This violation will be corrected her (date) ,. <br /> upporting documents included <br /> Describe actions taken or w;1l be taken to correct violation- <br /> Violation n - 2010007 - ubrn itted/maintained current Cert of Financial l espon ibilit /rnoch of financial <br /> assurance (TI 11 ) . <br /> This violation was corrected D This violation will be corrected b (date) . <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation <br /> --- <br /> Page of <br /> Rev 9/1$120 0 <br /> 1868 E Hazellon Avenue Stockton , Califorinia 95205 T 209 468-3420 1 F 209 40-4-01381 www sjgov or lE ll <br /> 1_ ' ' i.F�. t +iF ' ti • ri. '�' r am• +� r+ r •1.4�` Jft * � +s 'f �..�, a - �. �� � �r M-3WVAW '+ <br />