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� 1If1 �AI Environmental Health Department <br /> 11 V N <br /> u _ <br /> r Creotness grows here, <br /> Corrective Action Statement <br /> RE: July 28, 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: UNITED#5447 Submit completed form to: <br /> Facility address: 1469 E HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180781 ATTN: MARIA LOPEZ <br /> PR0231126 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#50-2060020-Spill buckets meet requirements, have been tested as required,and records kept <br /> for 36 mths(TCR 9a). <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: Spill bucket testing was sent to CUPA within 30 <br /> of testing via email. Test Results are attached and printed by the site for placement in the CUPA Binder <br /> Violation#52-2030036-Overfill prevention system has not been overridden and meets overfill requirements <br /> (TCR 9b). <br /> ® This violation was corrected ❑This violation will be corrected by(date): <br /> C31 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Overfill valve inspection was sent to CUPA within 30 <br /> of testing via email. Test Results are attached and printed by the site for placement in the CUPA Binder <br /> Page 2 of 4 <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 />