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Environmental Health Department <br />SA�}�OQ(1UI <br />COUNTY <br />tJreorness grows here. <br />Corrective Action Statement <br />RE: April 11, 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: AHMEDS SONS INC Submit completed form to: <br />Facility address: 1257 W YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10181329 ATTN: PAUL NSO <br />PR0231463 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #106 - Failure to submit a complete and accurate UST Response Plan. <br />15( 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: �,l �/ �[� 'J "Ag <br />(,JZ:),� _ 0-- LAX -1 o--3 CCAS 5" -d -L <br />Violation #110 - Failure to submit the "Underground Storage Tank Statement of Understanding and <br />Compliance Form". <br />Rev. 9/16/2020 <br />1This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation <br />Page 2 of 4 <br />-00 <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 />