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� 1If1 �AI Environmental Health Department <br /> 11 V N <br /> u _ <br /> r Greatness grows fere, <br /> Corrective Action Statement <br /> RE: June 05, 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 /> Maria Lopez at(209)616-3064 or melopez@sjgov.org. <br /> Facility name: fast and easy mart#103 Submit completed form to: <br /> Facility address: 8660 LOWER SACRAMENTO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181351 ATTN: MARIA LOPEZ <br /> PR0231161 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#3-2010013-Facility has submitted a complete and accurate UST Monitoring Plan.. <br /> ❑ 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 /> Violation#7-2010003-Owner/Operator submitted DO form and/or informed the CUPA of any change(s) <br /> within 30 days(TCR 10). <br /> ❑ 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 /> 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 />