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Environmental Health Department <br /> SAN JOAQUIN <br /> UNTY . <br /> Corrective Action Statement <br /> RE : January 14, 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. <br /> Also , describe what was done to correct the violation in the space provided below each violation . Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection . If you have any questions , <br /> please contact Paul Nso at (209) 468-3432 or pnso@sjgov . org . <br /> Facility name : 76 EXPRESS TIGER NO 1 Submit completed form to: <br /> Facility address : 5777 S FRENCH CAMP RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10182157 ATTN: PAUL NSO <br /> PRO505746 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 - Plot plan/site map not submitted or failed to completely show where monitoring is <br /> performed . <br /> EY�oThls violation was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included /,�r <br /> Describe <br /> �action taken or will be taken to correct violation : A.h1�'!' L 4Z <br /> Violation #110 - Failed to submit "Secondary Containment Testing Report Form " within 30 days after the test . <br /> l( This violation was corrected ❑ This violation will be corrected by ( date ) : <br /> ❑ Supporting documents included <br /> Describe actions taken or will b taken to correct violation : <br /> Page 2 of 4 <br /> Rev, 8/27/2019 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468 -3420 1 F 209 464-0138 1 www . sjcehd. com <br />