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r, SIN <br /> ANJ 0 AQ I I Environmental Health Department <br /> i'� C0UINTY <br /> Greatness grows here. <br /> Corrective Action Statement <br /> RE: July 28, 2023, 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 Shewit Woldearegay at(209)616-3063 or stwoldearegay@sjgov.org. <br /> AISLE 1 #2366, 4219 E MORADA LN, CERS ID: 10185183, PR0524617 <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report. <br /> Io 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: RTC was Sent 1/9/23. <br /> Violation#208-Failure to comply with the designated operator inspection requirements. <br /> Q 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: Future DO inspections to be completed <br /> within 30 days or less. <br /> Violation#210-Failure to provide initial training,train every 12 months,and have a trained employee <br /> present. <br /> P 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: DO Training completed 6/28/2023. <br /> Page 3 of 4 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue l Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />