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SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: September 09, 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 /> Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: LODI MUNI SERVICE CENTER Submit completed form to: <br /> Facility address: 1331 S HAM LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181549 ATTN:VICKY VANG-LEE <br /> PR0231332 1868 E HAZELTON AVENUE <br /> STOCKTON.CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> Q This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included rr r i <br /> Describe actions taken or will be taken to correct violation L6ga c j onIn [� F S 61 n0 U p3afe-A <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> ❑ This violation was corrected ;9 This violation will be corrected by(date): <br /> ❑ Supporting documents included ` <br /> Describe actions taken or will be taken to correct violation: l-r�/)P D 6S J'd ootc�4 Pc ra-ft c <br /> oo fTC �C�2 CLS Arc C 0 Ca C-1. <br /> Page 2 of 2 <br /> Rev 9/16/2020 <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 />