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SAN 10AQUIN Environmental Health Department <br />-- COUNTY -- <br />Greotness grows here. <br />Corrective Action Statement <br />RE: March 20, 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 />Maria Lopez at (209) 616-3064 or melopez@sjgov.org. <br />Facility name: FARMINGTON CIRCLE K Submit completed form to: <br />Facility address: 4469 S ESCALON BELLOTA RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10187403 ATTN: MARIA LOPEZ <br />PRO540158 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #11 - 4010012 - SPCC in writing, follows code seq/cross ref, good eng practice, mgt approval, items <br />not in place. <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: Attachment 2 under "Discharge Prevention Measures" <br />has been changed to Attachment 5, in order to reference inspection checklists. <br />Violation #20 - 4010017 - SPCC contains procedures for reporting a discharge. <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: Under "Countermeasures for Discharge <br />Discovery, Response and Cleanup", the plan lists who should be notified. <br />Under "Contact List" the plan lists the Personnel/Organization and their contact numbers. <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 />