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SAN JOApUIN Environmental Health Department <br /> ---COUNTY <br /> Greotness grows hen°. <br /> Corrective Action Statement <br /> RE:March 12,2024,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 MARKETPLACE Submit completed form to: <br /> Facility address: 1789 W CHARTER WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERSID: 10182247 ATTN KRISTINA SAETERN <br /> PRO506538 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#101-Failure to obtain a permit to operate from the EHD including but not limited to unpaid permit <br /> fees. I <br /> ❑ This violation was corrected This violation will be corrected by(date): 31(�I�-t-) <br /> rK Supporting documents included p <br /> Describe actions taken or will be taken to correct violation: IPA-1W,y 1S' /Utite,k At 6(LI <br /> we Ave- c+ol-t o@ 9,-e%cQl-- NS, w•Cl. <br /> %,,A4 e- <br /> Violation#107-Failure to submit and maintain complete and current financial responsibility documents. <br /> ❑ This violation was corrected This violation will be corrected by(date): 3I/N 12 H <br /> `9 Supporting documents included t� <br /> Describe actions taken or will be taken to correct violation: n//fn) CF2ri Led-rT D 0 17 tit A NQAt <br /> 4e4, All 6iL� js aPly4d,,4 n, CeQS 61>7 0k1 <br /> �dl.,�J I�f /ri •YNf lylhdtf. <br /> Page 2 of 3 <br /> Rnv 9/16/2020 <br /> 1868 E.Hazelton Avenue I Stockton,California 95205 1 T 200 468-3420 1 F 209 464-0138 1 www.sjgov.org1EHD <br />