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SAN 10 A Q U I N Environmental Health Department <br />Corrective Action Statement <br />RE: June 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 any questions, please contact <br />Allen Asio at (209) 616-3031 or allen.asio@sjgov.org. <br />Facility name: EXPRESS FUEL &MART <br />Facility address: 701 E DR MARTIN LUTHER KING JR BLVD <br />'ERS ID: 10180955 <br />PR0231059 <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: ALLEN ASIO <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #7 - 2010003 -Owner/Operator submitted DO form and/or informed the CUPA of any changes) <br />within 30 days (TCR 10). <br />This violation was corrected ❑This violation will be corrected by (date): <br />❑ Supporting documents included 1 <br />Describe actions taken or will be taken to correct violation: W� {� A V2 <br />V)Pi(>r j X1-2 �1chLi�i'e�►i��►� )&AIsi'levA �� �2�i'yhe, PI D1�'1k <br />Violation #10 - 2030074 -Annual Monitoring System Certification Form to the CUPA within 30 days of <br />completion of the test. <br />Rev. 9/16/2020 <br />►y <br />This violation was corrected ❑This violation will be corrected by (date): <br />❑ Supporting documents included �^1 <br />Describe actions taken or will be taken to correct violation: f� i e� F r�2 Pvf 1 Seh 1 b Yyti 1l-rl. <br />Pleafe s'ee Ike u4tcIzej r46wr T� �,oLs atca_begt, acijP.A o Le <br />�LU5 S'da1i'2k1 <br />Page 2 of 4 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjgov.org/EHD <br />