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Environmeifr. 000mentSAN 1QAQUIN <br /> s" OUNTY — — <br /> CBCT 0 9 2020 <br /> Corrective Action Statement ENVIRONMENTAL HEALTH <br /> RE : October 06 , 2020 , Underground Storage Tank inspection r'reF%\'kTiSERVICES <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: RANCHO SAN MIGUEL MARKET* Submit completed form to : <br /> Facility address : 610 S Cherokee Ln SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10184805 ATTN : CAROL PRESTO <br /> PR0521866 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #209 - Failure to conduct the designated UST operator visual inspection at least once every 30 <br /> days . <br /> [RI 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 : Karen Arnaiz our D . O will ensure that all dates <br /> from testing to repairs are documented correctly on the visual monthly inspection report . <br /> RECEIVED <br /> 0 C T 0 9 2020 <br /> ENVIRONNIENTAL HEALTH <br /> DEPARTMENT <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 209464-0138 1 www. sjgov. org/EHD <br />