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Environmental Health Department <br />-�- SAN_JOAQUIN <br />Si ` COUNTY-_ _ <br />Greatness grows here, <br />Corrective Action Statement <br />RE: April 29, 2021, Hazardous Waste inspection report <br />For each violation listed below, indicate if the violation has been corrected or will 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 form <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 />PRO539211 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #110 - Failed to keep signed copy of manifests from the designated facility for three years. <br />g 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: �`G�i� l `� �, ,C` G.b\'0— `c% <br />Violation #111 - Failed to comply with uniform hazardous waste manifest exception requirements. <br />fi3- This violation was corrected © This violation will be corrected by (date): <br />0 Supporting documents included 1y > ++ 1 <br />Describe actions taken or will be taken to correct violation: 1V C� T bL-� fn_e Je C C_:. <br />+k/L{ _ CkvnG k i1VLC� 1 k %�!eS ` -, '-"r C A 1 Ci � AO -A 'Us O A <br />Violation #113 -Failed to keep copies of consolidated manifesting receipts for three years. <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 />:, (A <br />\NC�_S C;k_C_ 2 <br />�I <br />c✓�ul <br />`L�r:�-zS�` <br />Ct'G2 [-� <br />_ S _ '4 - L4L�2; (� t L <br />C `�C <br />`71t7: , <br />C)ti1�,: <br />Page 2 of 3 <br />Rev, 9116!2020 <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 i www sjgov.org/EHD <br />