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SAN 10 A Q U I N Environmental Health Department <br /> ( r C) tj hl pI4Y <br /> r „ lip , , , <br /> Corrective Action Statement <br /> RE : August 26 , 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 Robert Lopez at (209) 953-6214 or rlopez@sjgov. org . <br /> Facility name : VERIZON WIRELESS LOWER JONES TRACT Submit completed form to: <br /> Facility address : 17720 W BACON ISLAND RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10144153 ATTN: ROBERT LOPEZ <br /> PRO512992 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #5 airFailed to electronically submit hazardous materials inventory for all reportable materials on <br /> site, <br /> This violation was corrected D This violation will be corrected by ( date ) : <br /> Supporting documents included <br /> Describe actions taken or will betaken to correct violation : <br /> Violation #6 - Failed to electronically submit a site map with all required content . <br /> ❑ This violation was corrected ❑ This violation will be corrected by ( date ) : <br /> Supporting documents included <br /> Des ribe actions taken or will be taken to correct violation : <br /> Violation #10 - Failed to electronically update the HMBP within 30 days of substantial change in operations , <br /> ❑ This violation was corrected ❑ This violation will be corrected by (date ) : <br /> 111'1 Supporting documents included <br /> Describe actions taken or will betaken to correct violation : <br /> Page 2 of 3 <br /> Rev, 0/27/2019 <br /> 1868 E . Hazelton Avenue Stockton , California 952051 T 209 468-3420 1 F 209 4641,,0138 1 www . sjcehd . com <br />