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Environmental Health Department <br /> SANJOAOUIN <br /> COUNTY. <br /> rc x° w 4 : <br /> Corrective Action Statement <br /> RE: June 02, 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 Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: TIGER EXPRESS STORES Submit completed form to: <br /> Facility address: 1399 E YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180675 ATTN:PAUL NSO <br /> PR0231464 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <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: ) 9 � ez 1."bl9�1 <br /> c 'l <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> ,121' 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: ft dfv,(-f hvc10ry <br /> rmct cCe� k� s _ <br /> ice► o A- f7k6i'M4 <br /> C �d o Q <br /> Violation#202-Failure to retain a paper or electronic copy of the permit to operate at the facility. C <br /> ❑ This violation was corrected OThis violation will be corrected by(date): J v <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Us <br /> 06 o ZZ <br /> L <br /> 1�l 14AI. <br /> Page 2 of 3 <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 />