Laserfiche WebLink
SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: October 28, 2020, Underground Storage Tank 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 <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Carol Presto at(209)616-3061 or cpresto@sjgov.org. <br /> Facility name: LODI MEMORIAL HOSPITAL Submit completed form to: <br /> Facility address: 975 S FAIRMONT AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180611 ATTN: CAROL PRESTO <br /> PR0231331 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <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 /> This was uploaded into CERS and submited day of inspection <br /> Violation#204-Failure to maintain records of repairs,lining,and upgrades on site,for the life of the UST. <br /> ff This violation was corrected ❑This violation will be corrected by(date): <br /> IY Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Elite IV has sent us a copy of the missing paper. THis has been inserted <br /> into the inspection binder <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> IX 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 /> We have contacted the DO and informed of the failure . They have asssured <br /> us it will not happen again <br /> Page 2 of 2 <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 />