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SAN JOAf1� N Environmental Health Department <br /> �1 <br /> li� --COUNTY— <br /> Corrective <br /> --COUNTY--Corrective Action Statement <br /> RE: March 21, 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,descnbe 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 Kristina Saetem at(209)616-3045 or ksaetern@sjgov,org. <br /> Facility name: THORNTON 76 Submit completed form to: <br /> Facility address: 8606 THORNTON RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID. 10180975 ATTN:KRISTINA SAETERN <br /> PR0232261 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#906-Failure to submit and maintain a current facility plat plan!site map. <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: Qa>\u Qa k Og 1922 ii�� t'tP31�TFC_ <br /> SE3- C �6m "� <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within30days. <br /> G/This violation was corrected ❑This violation will be corrected by(date): <br /> G}"Supporting documents included <br /> Describe actions taken or will be taken to correct violation: 11 t a�[ — <br /> Ct ., �•nli 3k�, cmc <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 /> Describe actions taken or will be taken to correct violation 2 <br /> ti � kA 1i <br /> Page 2 of 2 <br /> Rev,91160ZG20 <br /> 1868 E. Hazelton Avenue i Stockton,California 952051 T 209 468-3420 1 F 209 464-0138 1 www.slgov.ag/EHD <br />