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�l ►I��aAl I I N Environmental Health Department <br /> L-'r'.`' j COUNTY <br /> r o- Greotness grows here. <br /> Corrective Action Statement <br /> RE: May 29, 2020, 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 Nicholas Loehrer at(209)468-0623 or nloehrer(aD_sigov.orq. <br /> Facility name: EL FORASTERO MEXICAN FOOD Submit completed form to: <br /> Facility address: 306 W YOSEMITE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: none ATTN: NICHOLAS LOEHRER <br /> PR0541924 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 />