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SAN 10 A Q U I N Environmental Health Department <br />ii,7140` COLJNTY— <br />ci/"�,`l Greatness grows here. <br />Corrective Action Statement <br />RE: May 19, 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 Paul Nso at (209) 616-3049 or pnso@sjgov.org. <br />Facility name: QUIK STOP MARKET #551121 <br />Facility address: 1196 W LOUISE AVE <br />'ERS ID: 10180667 <br />PR0506233 <br />Violation #104 - No modified contingency plan. <br />C� This violation was corrected <br />❑ Supporting documents included <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: PAUL NSO <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />Phone list and emergency action plan has been posted and will be in binder onsite. <br />Violation #105 - No emergency coordinator available for emergency response. <br />rx <br />This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />Phone list and emergency action plan has been posted and will be in binder onsite. <br />Violation #605 -Failed to completely label containers or portable tanks of 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 />HW drums are properly labeled. Pictures attached. <br />Page 2 of 2 <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 <br />