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SAN JOAQUIN nviro menW Health Department <br />J . <br />Corrective Action Statement <br />RE: , 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 at <br />or. <br />Facility name: Submit completed form to: <br />Facility address: SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: none ATTN: <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />t3-. This violation was corrected ® This violation will be corrected by (date): <br />)3•= - Supporting documents included <br />Describe actions taken or will be taken to correct violation:��� <br />I iJ/ ✓r'W /t -A r�f2at::;i %Dt�- IDL,),y e- '502't0u"V'01'4 � <br />� L tA-) 1-) s l LJ=leogLP 1e' <br />6/--71�1 plbaluu s 6 <br />�d <br />c, l -t' i C Q57\11Y- � •� �z�� > ®� j i � (1��/ �P '�,2 <br />cL/n <br />Page 2 of 2 <br />Rev. 9116/202D <br />1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sigov.org/EHD <br />