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SAN 10 AQ U I N Environmental Health Department <br /> UN i Y <br /> Corrective Action Statement <br /> RE: November 08, 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 Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Supervalu, 1990 N PICCOLI RD, CERS ID: 10181455, PR0231820 <br /> Violation#208-Failure to comply with the designated operator inspection requirements. / (� <br /> This violation was corrected This violation will be corrected by(date): /�—/ O o <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> i I� 7�1�C.`,�✓./l <br /> G 1,Cn�?Jie f <br /> Page 4 of 4 <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 />