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SAN J O A Q U I N Environmental Health Department <br /> CC>U [J [ Y <br /> Corrective Action Statement <br /> RE: January 15, 2026, 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: WEST 12 RANCH Submit completed form to: <br /> Facility address: 3434 W HWY 12 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10186063 ATTN: MARIA LOPEZ <br /> PR0525384 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#13-1010006-Site Map with all required content electronically submitted. <br /> is 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: sl( <br /> l <br /> Page 2 of 2 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />