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SAN �� IIIN Environmental Health Department <br /> -CauNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: October 01, 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@sjgov.org. <br /> Facility name: BRAKE MASTERS#164 Submit completed form to: <br /> Facility address: 515 E YOSEMITE BLVD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184551 ATTN: NICHOLAS LOEHRER <br /> PR0521236 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#4-Failed to electronically submit the Business Activities or Owner/Operator Identification 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 /> 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 /> Describe actions taken or will be taken to correct violation: <br /> Violation#9-Failed to annually review and certify that the HMBP is complete and accurate by the due date. <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 3 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />