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SAN OA Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE : June 08 , 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 /> Elianna Florido at (209 ) 616 - 3050 or eflorido@sjgov. org . <br /> Facility name : PEP BOYS #0710 Submit completed form to : <br /> Facility address : 845 E DR MARTIN LUTHER KING JR BLVD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10181563 ATTN : ELIANNA FLORIDO <br /> PR0513936 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation # 102 - Failed to determine if a waste is a hazardous waste . <br /> 04 This violation was corrected ❑ This violation will be corrected by (date ) : <br /> A Supporting documents included /l <br /> Describe actions taken or will be taken to correct violation : i�. ca r ez� c� X20, I S <br /> Violation # 114 - Failed to keep signed copy of manifests from the designated facility for three years . <br /> 14� This violation was corrected ❑ This violation will be corrected by (date) : <br /> 10 Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> ("! p lips r1160 1k 7 ( i!(� ✓1.AC 6l /9 LOQ s > PJ�J <br /> f <br /> Violation #115 - Failed to comply with uniform hazardous waste manifest exception requirements . <br /> 11 This violation was corrected ❑ This violation will be corrected by ( date) : <br /> A Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> l <br /> I "is h o l o - ior,3 .Q „4- Apxb Occr &-4� >PA, <br /> �e > !� -- <br /> YPe <br /> Rev. 9/1612020 Page 2 of 5 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468 -34201 F 209 464- 0138 1 www . sigov . org/EHD <br />