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SAN JOAQUIN <br />(.l f <br />rep <br />RE: July 25, 2024, inspection ort <br />Environmental Health Department <br />Corrective Action Statement <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 />Lynsey Sammons at (209) 616-3067 or Isammons@sjgov.org. <br />SUBWAY # 65214, 2828 COUNTRY CLUB BLVD, CERS ID: 10657183, PR0540787 <br />Violation #9 - 1010003 -Business Owner/Operator ID and Business Activities pages electronically submitted <br />and are accurate. <br />L3" 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: <br />Violation #10 - 1010004 -Complete and accurate Hazardous Materials Inventory information electronically <br />submitted. <br />his violation was corrected ❑This violation will be corrected by (date): Q 4 t7S �OZ� <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Violation #11 - 1010005 - Site Map with all required content electronically submitted. <br />This violation was corrected 11 This violation will be corrected by (date): 0 b S a �� `l <br />❑ Supporting documents included <br />Rev. 9/16/2020 <br />Describe actions taken or will be taken to correct violation: <br />Page 4 of 5 <br />1868 E. Hazelton Avenue i Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />