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SAN JOAQUIN Environmental Health Department <br /> - COUNTY <br /> Corrective Action Statement <br /> RE: February 22, 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 Robert Lopez at (209) 953-6214 or rlopez@sjgov.org. <br /> Facility name: Costco Wholesale Logistics #4140 Submit completed form to: <br /> Facility address: 2115 S Sinclair Ave SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10140899 ATTN: ROBERT LOPEZ <br /> PR0528771 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#2-Failed to initially complete and electronically submit a HMBP. <br /> This violation was corrected ❑ This violation will be corrected by (date): <br /> f� Supporting documents included <br /> Describe actions taken or will be taken to correct violation: HMBP has been submitted in CERS - see <br /> CERS ID 10140899 <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): <br /> 6a' Supporting documents included <br /> Describe actions taken or will be taken to correct violation: HMBP has been submitted in CERS - see <br /> CERS ID 10140899 <br /> Violation#4-Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br /> M' This violation was corrected ❑ This violation will be corrected by (date): _ <br /> G� Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Business Activities and Owner/Operator <br /> Identification page included in HMBP CERS submittal - see CERS ID 10140899 <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 />