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h"""• SAN,,JOAQUIN Environmental Health Department <br /> T . <br /> COL) NTY <br /> c' r Greatness grows peri,. <br /> Corrective Action Statement <br /> RE: March 30, 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 /> COUNTRY MARKETPLACE, 1789 W CHARTER WAY, CERS ID 10182247, PR0506538 <br /> Violation#121 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <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 /> Violation#124- "Overfill Prevention Equipment Inspection Report Form" not submitted within 30 days of <br /> inspection. <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 /> Violation#202 - Failure to maintain the "Facility Employee Training Certificate" on-site (after October 1, <br /> 2018). <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 /> Page 3 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 />