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Jan, 10. 2 0 2 0 7: 17 PM Photos X Paperwork Statenteu o' 0 7 5 0 P. 5 <br /> 3.1 am authorized to submit this certification on behalf of the Respondent. <br /> 4-I am aware that there are significant penalties for submitting false information,including the possibility of a fine <br /> and/or imprisonment for known violations. (HSC 25191) <br /> Name: Vj&NIJ V/&0P Tide: Cloffit9w <br /> Signatu Date, 1-2-AO <br /> Page 2 <br /> Environmental Health <br /> Department <br /> Corrective Action Statement <br /> RE: December 06,2019,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 /> farm 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@s" og �'.org. <br /> Facility name: NAGLEE BURK IRRIGATION DIST St[bmit completed forth to: <br /> Facility address: 18961 S LAMMERS RD SJC ENVIRONMENTAL HEALTH <br /> CERS ID: 10182737 AKWRAS LOLHRBR <br /> PRO519686 1868 B HAZEL'TON AVBN(IB <br /> STOCKfON,CA 95205 <br /> Violation#2-Failed to complete and electronically submit a hazardous materials business plan. <br />