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SA J OAA I N Environmental Health Department <br /> Greorn#ss �; pvt here. <br /> Corrective Action Statement <br /> RE: May 20, 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 fol <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Frederick Ernest at(209) 616-3026 or fernest@sjgov.org. <br /> Facility name: Ross Roberts Truck Repair Inc Submit completed form to: <br /> Facility address: 641 S Harrison St SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10723408 ATTN-. FREDERICK ERNEST <br /> PR0520616 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 O'This violation will be corrected by (date): -t�wft <br /> Liz <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> LK 9Violation #5 -Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> ❑ This violation was corrected 13'This violation will be corrected by(date): <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation. <br /> � n <br /> Violation #6 - Failed to electronically submit as site map with all required content. <br /> ❑ This violation was corrected 4d This violation will be corrected by (date): Zi <br /> supporting documents included <br /> Describe actions taken or will be taken to correct violation: W1 <br /> Rev.911612020 Page 2 of 4 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />