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c°rll ,O�nlll� Environmental Health Department <br /> N <br /> QU <br /> Y <br /> !L.IrCOUNTY <br /> � '`" GfQotn�Si gr�w� here, <br /> Corrective Action Statement <br /> RE: October 22, 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 Lydia Baker at(209)616-3046 or(baker@sjgov.org. <br /> Facility name: STOCKTON MARIPOSA Submit completed form to: <br /> Facility address: 6540 S AUSTIN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10784968 ATTN: LYDIA BAKER <br /> PR0545413 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#103-Failed to retain hazardous waste determination including waste analysis on site for 3 years. <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#121 -Failed to maintain written record for each shipment of recycled or exempted oil for 3 years. <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 />