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QUAc SAN J OA Q U I N Environmental Health Department <br /> 470 __OUNTY- - <br /> cr,: Greotness grows here. <br /> Corrective Action Statement <br /> RE: November 05, 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 or jalaniz1 @sjgov.org. <br /> Facility name: CENTRISYS CORP Submit completed form to: <br /> Facility address: 825 PERFORMANCE DR SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10187373 ATTN: JOHN ALANIZ <br /> PR0538555 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#102-Failed to determine if a waste is a hazardous waste. <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#110-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 /> 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 /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Page 2 of 4 <br /> Rev.812712019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />