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N40IIIN Environmental Health Department <br />I�1 1J <br />CauNTY <br />Greatness grows here. <br />r. <br />Corrective Action Statement <br />RE: October 21, 2020, 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 Elianna Florido at (209) 616-3050 or eflorido@sjgov.org. <br />Facility name: Safeway 1648 Submit completed form to: <br />Facility address: 2449 W Kettleman Ln SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10156529 ATTN: ELIANNA FLORIDO <br />PR0538959 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #303 - Failed to maintain all communication or alarm systems, spill control, or decontamination <br />equipment. <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 2 <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 />