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3 A N J O A Q U I N Environmental Health Department <br />cCu�, <br />Corrective Action Statement <br />RE: January 13, 2025, 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 />Haza Saeed at (209) 953-6212 or hsaeed@sjgov.org. <br />Facility name: KNIFE RIVER Submit completed form to: <br />Facility address: 400 S LINCOLN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />,ERS ID: 10183985 ATTN: HAZA SAEED <br />PR0522005 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 _ <br />Violation #3 - 4030038 - SPCC has been implemented.utN <br />9 This violation was corrected [ This violation will be corrected by (date): In <br />Pt Supporting documents included {l <br />Describe actions taken or will be taken to correct violation: <br />S (62/l3c0 i a (2 <br />E2T <br />Z� SEC,o,joAeY riUSp�'Tro� <br />(KN��Qwert' �s eaoraw�w wrist �4aJ Caczr�'7L Tb SET i2�EC��'c�rc�. <br />Violation #8 - 4030039 - SPCC has been implemented within 6 months of amendment. E�tsiNE� S-ro+WP <br />2 W e4y'S k1A1X ? <br />❑ This violation was corrected This violation will be corrected by (date): <br />❑ Support <br />ing documents included <br />Describe actions taken or will be taken to correct violation: � KI S H i4 -S g�,/.� 5(.t,�„Ka-f,✓TED Fort <br />JZE c*4eQTCFI L [,)E A IVL6 ST tu- A wr3iT ttje? i(WE ENC, r.ucCfL'S <br />S(44)r1o"A-> L4>6 SHoUwlsd2 igAt_h THrc L 4&)Y r(KmC6 i PDA.. T �>as6e <br />I � o4-tC.to(=? #&,2E TNarJ 4 eyGcpr_E GJC—Effj5ib A4ri- w.cs�% <br />Violation #11 - 4010012 -SPCC in writing, follows code seq/cross ref, good eng practice, mgt approval, items <br />not in place. <br />This violation was corrected <br />®, Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: Sf� �'���(E)7 <br />Page 2 of 3 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />