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DECEIVED <br /> SEPI 2 7172 <br /> Environmental Health Department <br /> SAN VIRONMENTAL HEALTH <br /> - ' " DEPARTMENT <br /> Corrective Action Statement <br /> RE : August 24, 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 . Also , <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed <br /> form with the Return to Compliance Certification within 30 days of inspection . If you have any questions, please <br /> contact Carol Presto at (209) 616-3061 or epresto@sjgov.org . <br /> MIRACLE MILE MARKET, 244 W HARDING WAY, CERS ID: 101807790 PR0231137 <br /> Violation #1t0 - Failure to submit the "Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> [''This violation was corrected 13 This violation will be corrected by (date ) : <br /> 0 supporting documents included <br /> Describe actions taken or will be taken to correct violation : NOWNEEMEND <br /> MIN <br /> SWOOMMONOL <br /> Violation #115 - Failure to submit "Monitoring System Certification Form" within 30 days of completion of the <br /> test. <br /> Ela This violation was corrected D This violation will be corrected by (date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation : n <br /> Violation #116 - Failure to submit the "Spill Container Testing Report Form" within 30 days. <br /> B3 Ihis violation was corrected ❑ This violation will be corrected by (date) : <br /> E3 Supporting documents included <br /> Describe actions takers or will be taken to correct violation: <br /> 1n le L I � ' 1/ Wt q hlt � 1,. v p <br /> Page 3 of 4 <br /> Rev. 9/76/2020 <br /> 1868 E . Hazelton Avenue i Stockton , California 95205 i T 209 468-3420 1 F 209 464-0138 1 www . sjgov. org/EHD <br />