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SAN MOWN Environmental Health Department <br /> COUNTY <br /> Corrective Action Statement <br /> RE. November 26, 2019, Hazardous Waste 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 John Alaniz at(209)468-3147 orjalanizl@sjgov.org. <br /> Facility name: MOE AUTO REPAIR Submit completed form to: <br /> Facility address: 2255 S AIRPORT WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 90185223 ATTN:JOHN ALANIZ <br /> PR0538520 9868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#102-Failed to determine if a waste Is a hazardous waste. <br /> 1jf- Th1s violation was corrected 13 This violation will be corrected by(date): <br /> J <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#910-Failed to keep signed copy of manifests from the designated facility for three years. <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 /> LN <br /> �ti�t he_ n s 4 <br /> Violation#113-Failed to keep copies of consolidated manifesting receipts for three years. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> 12 Supporting documents included l <br /> Describe actions taken or will be taken to correct violation: 'i� -V,)1 1 - <br /> Rev.M712019 Page 2 of 3 <br /> 1868 E.Hazelton Avenue r Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0938 1 www.sjoehd.com <br />