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SAN J 0 AQ U I N Environmental Health Department <br /> CUUNTY <br /> ir! <br /> Grcotness grows here, <br /> Corrective Action Statement <br /> RE: February 15, 2022, 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 /> Facility name: E F KLUDT&SONS INC Submit completed form to: <br /> Facility address: 1126 E PINE ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181397 ATTN: VICKY VANG-LEE <br /> PR0231364 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> 0 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: Off!' GG�'1 Ni►tCtnlllA/f <br /> ewwl�j)�lhas z <br /> Violation#110-Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <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: i nJ <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> 19 This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> r <br /> Describe[actions taken or will be taken to correct violation: G <br /> 6 Ih <br /> Page 2 of 2 <br /> Rev.911 612020 <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 />