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*� SQN����QU�IV Environmental Health Department <br /> 'i_T ----CdUNI Y.— <br /> Greotness grows here. <br /> Corrective Action Statement <br /> RE: February 25, 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: SHELL FOOD MART Submit completed form to: <br /> Facility address: 2320 N ELDORADO ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182111 ATTN:LYNSEY SAMMONS <br /> PR0231084 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#11 -2030048-Sec containment testing conducted per requirements&records kept for 36 mths <br /> (TCR 9d). <br /> ❑ 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#56-2030013-DO inspections completed at least every 30 days and meet all requirements(TCR <br /> 12). <br /> /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 /> ` r Y)5 <br /> c Y, ,r <br /> V <br /> Page 2 of 2 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue Stockton,California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />