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SAN JOAQUIN Environmental Health Department <br /> - <br /> Corrective Action Statement <br /> RE: August 20, 2024, 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 form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Paul Nso at(209)616-3049 or pnso@sjgov.org. <br /> Facility name: COSTCO WHOLESALE#658 Submit completed form to: <br /> Facility address: 3250 W GRANT LINE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10146285 ATTN: PAUL NSO <br /> PR0518288 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#12-2010009-Secondary containment test results submitted to the CUPA within 30 days after the <br /> test.. <br /> 14 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 /> The testing contractor has been informed of the delay in submitting the testing report to <br /> the agency. The testers will ensure testing and submittal of test reports will be submitted <br /> Ina timely manner. <br /> Violation#51 -2030035-UST system is operated to prevent unauthorized release,including spills and <br /> overfills. <br /> TBD,dependent <br /> ❑ This violation was corrected This violation will be corrected by(date): arrival of materials <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> JF Petro/Jones Covey confirmed with the CUPA that a permit is NOT required to install the <br /> "drip/deflector plates". Once materials arrive, installation will be completed. <br /> Page 2 of 3 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />