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' SAN�IOAQOIN Environmental Health Department <br />i. <br />i, COUNTY <br />COUNTY ,.. . <br />Gieolness yrowi. here. <br />Corrective Action Statement <br />RE: October 11, 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 violation. Submit this completed <br />form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br />contact Claudia Muro at (209) 468-3429 or cmuro@sjgov.org. <br />Facility name: <br />Facility address <br />'ERS ID: <br />STOCKTON SURGERY CENTER <br />8011 DON AVE <br />10187381 <br />PR0541467 <br />Violation #104 - No modified contingency plan. <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: CLAUDIA MURO <br />1868 E HAZELTON AVENUE <br />S70CKTON, CA 95205 <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: Contingency plan has been updated and posted <br />at the facility. (See attached copy of updated plan) <br />This violation was corrected <br />Violation #105 - No emergency coordinator. <br />❑ <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: Contingency plan has been updated and posted <br />at the facility. (See attached copy of updated plan and emergency coordinator contact information) <br />Page 2 of 2. <br />Rev. erzrrzo�o <br />1868 E. Hazelton Avenue I Stockton, California 95205 (T 209 468-3420 I F 209 464-0138 I www.sjcehd.com <br />