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_o 6 (Z <br />SAN JOAQUIN <br />--- COUNTY----- <br />Environmental Health Department <br />Corrective Action Statement <br />RE: May 26, 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 Paul Nso at (209) 616-3049 or pnso@sjgov.org. <br />Facility name: AM PM HAMMER/15 FOOD #83113 <br />Submit completed form to: <br />Facility address: 3250 W HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID:10180825 ATTN: PAUL NSO <br />101808224 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #203 - Failure to maintain monitoring, maintenance, and follow up action records. <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 #207 - DO monthly reports not maintained on site for 12 months or for 36 months (after October 1, <br />2018). <br />❑ This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />Page 2 of 3 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />