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Y�OAQUIN Environmental Health Department SANs►. � COUNTY`, Corrective Action Statement RE: April 29, 2021, Hazardous Waste inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Haza Saeed at (209) 953-6212 or hsaeed@sjgov.org. Facility name: Delta Water Supply Project Submit completed form to: Facility address: 11373 N LOWER SACRAMENTO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT CE.RS ID: 10423735 ATTN: HAZA SAEED PR0539211 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Violation #110 - Failed to keep signed copy of manifests from the designated facility for three years. This violation was corrected ❑ This violation will be corrected by (date): Oq 1 p'JZp2,I a Supporting documents included Describe actions taken or will be taken to correct violation: Violation #111 - Failed to comply with uniform hazardous waste manifest exception requirements. w. This violation was corrected ❑ This violation will be corrected by (date): p ❑ Supporting documents included Describe actions taken or will betaken to correct violation: C ' 'g!4= SAcwmc+w^ fig_ CAr CC, e k -b *nn Sa�s,'L+,4 -- iCleehs rG��r I Lu f41% aA n:gL3i 69:4 MC4W IP -tt:t Violation #113 - Failed to keep copies of consolidated manifesting receipts for three years. X, This violation was corrected ❑ This violation will be corrected by (date): d G5 42 ❑ Supporting documents included Describe actions taken or will be taken to correct violation: Page 2 of 3 Rev, 911612620 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov org1EHD