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SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE : March 15 , 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 Kristina Saetern at (209) 616-3045 or ksaetern@sjgov. org . <br /> Facility name : COUNTRY MART GAS & FOOD Submit completed form to : <br /> Facility address : 34243 S CHRISMAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181085 ATTN : KRISTINA SAETERN <br /> PR0231801 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #208 - Failure to comply with the designated operator inspection requirements . <br /> 0 This violation was corrected ❑ This violation will be corrected by (date) : <br /> ❑ Supporting documents included � A, ,n, // <br /> Describe actions taken or will be taken to correct violation : C,^,�-[s�+� 7 `� Com. O <br /> VW <br /> AN�j T�fes� � S�"�VT a f}�1Tj 1�F C�� i' t� C T 1�_ /7) A z_ L _� AT/E le� T� <br /> Page 2 of 2 <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 />