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S A N:10A Q U I N Environmental Health Department <br /> t <br /> i L_ 0UlNI Y <br /> G �ntnrtt 0 +w• hi, <br /> Corrective Action Statement <br /> RE March 31, 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 Retum to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Kristina Saetem at(209)616-3045 or ksaetem@sjgov org <br /> Facility name: VAN DE POL ENT INC-PRIMARY Submit completed form to <br /> Facility address 4895 S AIRPORT WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10185023 ATTN: KRISTINA SAETERN <br /> PR0526970 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation #10 -4010009 -5 year review performed on SPCC and documented. <br /> W'This violation was corrected D This violation will be corrected by(date): <br /> ❑ Supporting documents Included / ,�` ,, <br /> Describe actions taken or will be taken to correct violation: 1 Vlb.j V j2v &—Atre j A� 1 S <br /> Rear 9/1W020 Page 2 of 2 <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 />