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SQJQAHIN Environmental Health Department <br />—COUNTY -- <br />7". <br />Greatness L rows <br />Corrective Action Statement <br />RE: April 29, 2021, Hazardous Materials inspection report <br />For each violation listed below, indicate if the violation has been corrected orwill be corrected by a certain date. Also, <br />describe what was done to correct the violation in the space provided below each violation. Submit this completed farm <br />with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br />Haza Saeed at (209) 953-6212 or hsaeed@sjgov.org. <br />Facility name: Delta Water Supply Project Submit completed form to: <br />Facility address: 11373 N LOWER SACRAMENTO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10423735 ATTN: HAZA SAEED <br />PR0539212 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #4 - Failed to electronically submit the Business Activities or Owner/Operator Identification page <br />❑ This violation was corrected This violation will be corrected by (date): (A8^C� Z�z/ <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />(� <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): _d a i4 11202 l <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Violation #6 - Failed to electronically submit a site map with all required content. <br />❑ This violation was corrected This violation will be corrected by (date): 0 <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Page 2 of 4 <br />Rev, 9116!2020 <br />1868 E Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www sjgov.org/EHD <br />