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�„ HAWN Environmental Health Department <br /> COUNTY— <br /> Greatness grows here, <br /> Corrective Action Statement <br /> RE: May 09, 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 Stacy Rivera at(209)616-3043 or srivera@sjgov.org. <br /> Facility name: JAMAR SERVICE Submit completed form to: <br /> Facility address: 4075 E MAIN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180873 ATTN: STACY RIVERA <br /> PR0231667 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#110-Failure to submit the"Underground Storage Tank Statement of Understanding and <br /> Compliance Form". <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> 00 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: CUC � <br /> Violation#122-Failure to implement corrections and submit written response within 30 days of receiving the <br /> report..J <br /> �[t This violation was corrected ❑This violation will be corrected by(date): <br /> 00 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <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 />