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r�` SANS!0 A 0 U I N Environmental Health Department <br /> :LA I i*, —COUNTY— <br /> Greatness grows here. <br /> Corrective Action Statement <br /> RE: February 19, 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 form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions,please contact <br /> Stacy Rivera at(209)468-3440 or sriverapslgov.orq, <br /> Facility name: BILLS 76 Submit completed form to: <br /> Facility address: 633 EVICTOR RD STE A SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS 1D: 10180603 ATTN:STACY RIVERA <br /> PR0232519 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#202-Failure to maintain the"Facility Employee Training Certificate"on-site(after October 1, <br /> 2018). <br /> XThis violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe acUoRs taken or will be taken to correct violation: <br /> 1 G w InI< �j <br /> Violation#209-Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days. <br /> VThis violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe a n to n or will a taken to carrt wclation: <br /> ?US <br /> Page 2 of 2 <br /> Rev.8WI2059 <br /> 1868 E. Hazelton Avenue) Stockton,California 952051 T 209 468-34201 F 209 464.0138 1 www,sicelid.com <br />