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qUINEnvironmental Health Department <br /> SANJOAQ <br /> Greotness grows hc,,, <br /> Corrective Action Statement <br /> RE: May 03, 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. <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 Lydia Baker at(209)616-3046 or(baker@sjgov.org. <br /> Facility name: PACIFIC AVE CHEVRON Submit completed form to: <br /> Facility address: 6633 PACIFIC AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10594654 ATTN: LYDIA BAKER <br /> PR0514447 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 /> 0 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 /> Manifests are attached and will be kept for 3 years in environmental box. <br /> Violation#111 -Failed to comply with uniform hazardous waste manifest exception requirements. <br /> 0 This violation was corrected ❑This violation will be corrected by (date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Manifests are attached. <br /> Violation#403-Failed to keep hazardous waste containers closed except when adding or removing <br /> hazardous waste. <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 /> Lid was secured same day as violation by maintenance team. <br /> Page 2 of 3 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 ( T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br /> i <br />