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ISAN JDACUN Environmental Health Department <br />Corrective Action Statement <br />RE: October 29, 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 />Michael Suszycki at (209) 598-7001 or msuszycki@sjgov.org. <br />Facility name: BURGER KING #9261 Submit completed form to: <br />Facility address: 700 N MAIN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10182171 ATTN: MICHAEL SUSZYCKI <br />PR0520717 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #3 -1010017 - Business plan readily available to site personnel responsible for emergency <br />response or training. <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 />6,'p 001A -Ar/ ,/r"F"V s r �,./&^ G t:rp- S , <br />Violation #14 -1020002 - Provided initial and annual training and maintained training records for a minimum <br />of three years. <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 />-.S&-,4,m . -#c/ "A. cin .aa P5, <br />Page 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/EHD <br />