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Environmental Health Department <br />Corrective Action Statement <br />RE: June 09, 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.Also, <br />describe what was done to correct the violation in the space provided below each violation. Submit this completed <br />form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br />contact Frederick Ernest at (209) 616-3026 or fernest@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: FREDERICK ERNEST <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to:SWISS AMERICAN SAUSAGE CO <br />10184217 <br />251 DARCY PKWY <br />PR0520816 <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): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on site <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 />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): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Page 2 of 3 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD