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SAN J QQ n U I N Environmental Health Department <br /> ' Grtetness glow% hers <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 /> COSTCO WHOLESALE#658, 3250 W GRANT LINE RD, CERS ID: 10146285, PR0518288 <br /> Violation#56-2030013-DO inspections completed at least every 30 days and meet all requirements(TCR <br /> 12). <br /> M This violation was corrected ❑This violation will be corrected by(date): <br /> gq Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> The inspection was originally signed and dated on 11/16/2023 by Bob Specht. Belshire <br /> discovered during an internal QC process that an amendment was needed to sections 3 and 5 <br /> of the DO inspection report. To maintain transparency after making the amendment on 12/13/2023, <br /> we had the operator (Audra Shriver) print, sign, and date the amended inspection on 12/13/2023. <br /> Page 3 of 3 <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 />