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SAN 1 OAQ U I N Environmental Health Department <br /> —COUNTY <br /> Corrective Action Statement <br /> RE* October 31, 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 Also <br /> describe what was done to correct the violation in the space provided below each vkolation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. if you have any questions,please contact <br /> Elianna Florido at(209)468-0343 or efloridoftgov org. <br /> Smart& Final#403, 147 N Wilson Way, CERS ID: 10452535, PR0539378 <br /> Violation#109-Failed to send generator manifest copies to DTSC within 30 days. <br /> UM1 This violation was corrected _0 This violation will be corrected by(date): 10-31-19 <br /> VSupporting documents included <br /> Descrbe actions taken or will be taken to correct v!olahon See cc403 Corrective Action Statement doc_ <br /> Violation#110-Failed to keep signed copy of manifests from the designated facility for three years. <br /> 1 This violation was corrected 1((This violation will be corrected by(date): 11-01-19 <br /> .F Supporting documents included <br /> Describe actions taken or will be taken to correct violation See cc403 Corrective Action Statement doc. <br /> Violation#111 -Failed to comply with uniform hazardous waste manifest exception requirements. <br /> This violation was corrected This violation will be corrected by(date): 10-31-19 <br /> 1�Supporting documents included <br /> Describe actions taken or will be taken to correct violation See cc403 Corrective Action Statement doc_ <br /> Page 3 of 5 <br /> Rev 812712019 <br /> 1868 E. Hazelton Avenue I Stockton California 952051 T 209 468.3420 1 F 209 464-0138 1 www sjcehd.com <br />