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Feb . 09 . 2021 01all PM Ernie ' s General Store & D 2099312871 PAGE . 2 / 3 <br /> A N Environmental Health Department <br /> SAWM1 11 <br /> . , <br /> Corrective Action Statement <br /> RE : January 28 , 2021 , 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 or srlveransjgov. org . <br /> Facility name; ERNIE $ GENERAL STORE Submit completed form to: <br /> Facility address : 4407 E WATERLOO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID ; 10180913 ATTN : STACY RIVERA <br /> PRO231761 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #203 - Failure to maintain monitoring records for 36 months and maintenance records for 60 <br /> months, <br /> his violation was corrected This violation wilt be corrected by (date): 174 "2 ® '�-I <br /> Supporting documents Included <br /> Describe actions taken or will be taken to correct violation : <br /> ®T rk s CLr we. o r\ <br /> Violation 8206 - Failure to comply with the designated operator Inspection requirements . ( 1 <br /> his violation was corrected Q This violation will be corrected by (date): 1 ) LI i9 t A �? 1 <br /> O Supporting documents Included <br /> Describe actions to en or will be taken to correct violation : <br /> Violation 9209 - Failure to maintain a copy of the "Facility Employee Training Certificate" onsite . <br /> This violation was corrected © This violation velli be corrected by (date):04 <br /> (3 Supporting documents Included <br /> Describe actions ken or will be taken to correct violation : <br /> Page 2 of 2 <br /> Rev, 8/27/2010 <br /> 1868 E . Hazelton Avenue ( Stockton , California 95205 T 209 468-3420 F 209 464-0138 1 www. sjcehd , 0orn <br /> Received Time Feb , 9 . 2021 11134AM No , 6593 <br />