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COMPLIANCE INFO_2021 (2)
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COMPLIANCE INFO_2021 (2)
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Last modified
3/2/2021 9:46:33 AM
Creation date
2/22/2021 9:24:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0520663
PE
1919
FACILITY_ID
FA0006729
FACILITY_NAME
JACK IN THE BOX #3427
STREET_NUMBER
1081
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95337
APN
21935042
CURRENT_STATUS
01
SITE_LOCATION
1081 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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N40IIIN Environmental Health Department <br /> I�1 1J <br /> COUNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: February 19, 2021, 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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: JACK IN THE BOX#3427 Submit completed form to: <br /> Facility address: 1081 S MAIN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182135 ATTN: KRISTINA SAETERN <br /> PR0520663 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <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#7-Failed to electronically submit an adequate ER procedures for a release or threatened release. <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 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 />
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