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SKJI Environmental Health Department <br /> COUNTY <br /> r � <br /> 1={k*•`r Greatness grows horn. <br /> Corrective Action Statement <br /> RE: December 03, 2019, Hazardous Materials inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. <br /> Also, describe what was done to correct the violation in the space provided below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact Robert Lopez at (209) 953-6214 or rlopez@sjgov.org. <br /> Facility name: MIDGLEYS PUBLIC HOUSE Submit completed form to: <br /> Facility address: 296 LINCOLN CENTER STE 296 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: none ATTN: ROBERT LOPEZ <br /> PRO545066 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation #2 - Failed to complete and electronically submit a hazardous materials business plan. <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 /> Violation #3 - Failed to establish and implement a hazardous materials business plan. <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 /> Violation #4 - Failed to complete and/or submit the Business Activities or Owner/Operator Identification <br /> page. <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 /> Page 2 of 5 <br /> Rev.8/27/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />