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S Q N J 0 A Q U I N Environmental Health Department <br /> _ . 00UN {. <br /> Corrective Action Statement <br /> RE: December 24, 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 /> Monica De Anda at(209)616-3063 or mdeanda@sjgov.org. <br /> NORTH POLE GAS & FOOD INC, 574 W GRANT LINE RD, CERS ID: 10181065, PR0231405 <br /> Violation#0-2030073-Facility has corrected cited violations within 30 days of receiving report. <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#0-2030074-Annual Monitoring System Certification Form to the CUPA within 30 days of <br /> completion of the test. <br /> 1K 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 violati n: CCJ I /Iil L���Z�1 12 I <br /> V ti 4� _ <br /> Page 3 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 />