Laserfiche WebLink
S A N J O AQ U I N Environmental Health Department <br /> COUNTY <br /> . Greac.�eys 3rows <br /> Corrective Action Statement <br /> RE: March 07, 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. 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: WATERLOO LIQUOR Submit completed form to: <br /> Facility address: 2512 E WATERLOO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181585 ATTN: PAUL NSO <br /> 1868 E HAZELTON AVENUE <br /> PR0232418 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: <br /> r,..A I2- <br /> Violation#109-Failure to submit"Designated Underground Storage Tank Operator Identification Form" <br /> within 30 days. <br /> 4 This violation was corrected ❑This violation will be corrected by (date): <br /> 0 Supporting documents ineludod <br /> Describe actions taken or will be taken to correct violation: <br /> V\i-"k Y) M z.i, 1 J i O ,—CA �"•'►�t t/�o:7G1��{ V O i Yl �:� <br /> Page 2 of 4 <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 />