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SAN JOARIN Environmental Health Department <br /> COUNTY L <br /> Corrective Action Statement <br /> RE : April 27 , 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 . <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 Elianna Florido at ( 209 ) 616- 3050 or eflorido@sjgov . org . <br /> Facility name : WATERLOO LIQUOR Submit completed form to : <br /> Facility address : 2512 E WATERLOO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181585 ATTN : ELIANNA FLORIDO <br /> PR0232418 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation # 122 - Failure to implement corrections and submit written response within 30 days of receiving the <br /> report . <br /> II 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 : Lori e rt ° An C`atrPcjt - � <br /> e 1 4r i l�P i s M rn t . +1 r �J f3 a <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> d 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 /> LAI,ei ( 'ew v2 C.� 444'r d <br /> Rev. 9716!2020 Page 2 of 3 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468 - 3420 1 F 209 464 - 0138 1 www . sjgov . org/ EHD <br />