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SKJOAQUIN <br /> Environmental Health Department <br /> COUNTY <br /> Corrective Action Statement <br /> RE: November 04, 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: DFA Medici Associates, LP Submit completed form to: <br /> Facility address: 242 N SUTTER ST#700 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10151121 ATTN.- ROBERT LOPEZ <br /> PR0538220 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation #2 - Failed to initially complete and electronically submit a HMBP. <br /> X 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: completed form on CERS website 12/04/2020 <br /> Violation#3 -Failed to establish and implement a hazardous materials business plan. <br /> ❑ This violation was corrected This violation will be corrected by (date): January 31, 2021 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Contacted a Hazardous Management Consulting <br /> Company to assist with submission of the correct procedures - submitting for approval a training <br /> policy to ensure compliance with SHC EHD and EPA starndards <br /> Violation #4 - Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br /> X 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: completed form on CERS website 12/04/2020 <br /> Page 2 of 5 <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 />