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SAN J O A Q U I N Environmental Health Department <br /> r; - CQUNTY-- <br /> C;„ y Gareatn+ess gr�ow5 Frere. <br /> Corrective Action Statement <br /> RE: October 04, 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. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Nicholas Loehrer at(209)468-0623 or nloehrer@sjgov.org. <br /> Facility name: INDIAN CAFE Submit completed form to: <br /> Facility address: 2128 DANIELS ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: none ATTN: NICHOLAS LOEHRER <br /> PR0541679 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 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 />