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SAN JOAQUIN Environmental Health Department <br /> Corrective Action Statement <br /> RE: September 11, 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 anv questions, ;)lease contact <br /> Aaron Madera at(209)616-3065 or amadera@sjgov.org. <br /> ST JOSEPHS HOSPITAL, , CERS ID: 10181391, PR0231036 <br /> Violation#13-2010017-Spill bucket testing results submitted to the UPA within 30 days of testing. <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included �_M <br /> Describe actions taken or will be taken to correct violation: 9000a it,/ V <br /> lr*l C-40R g18aUT <br /> j9,JQ)K 66715A MARKTI.OdS <br /> Violation#14-2010018-Overfill prevention equipment inspection report form submitted to the UPA within 30 <br /> days. <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included ec��,,,,,�� r� (n,,/1 e <br /> Describe a��ctioons takeln o`r will be tttak,�en to�correct violation: cJf�F�" Wt'M gNV�I<tiLAgMAT <br /> ru <br /> Violation#53-2010007-Submitted/maintained current Cart of Financial Responsibility/meth of financial <br /> assurance(TCR 11). <br /> IQ/IT s violation was corrected ❑This violation will be corrected by(date): <br /> Supporting documents included a /� <br /> Describe actions taken or will be taken to correct violation: 109QtgfQ W Jl1 M t t t O <br /> Page 3 of 3 <br /> tev.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 />