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a � Environmental Health Department <br /> IN <br /> Corrective Action Statement <br /> RE: July 20, 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 <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Carol Presto at(209)616-3061 or cpresto@sjgov.org. <br /> Facility name: H&M-BW##98 Submit completed form to: <br /> Facility address: 2501 JACKSON AVE SJC ENVIRONMENTAL.HEALTH DEPARTMENT <br /> CERS ID: 10181511 ATTN: CAROL PRESTO <br /> PRO518566 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#104-No modified contingency plan. <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#110-Failed to keep signed copy of manifests from the designated facility for three years. <br /> ❑ This violation was corrected This violation will be corrected by(date): _ 6 <br /> ❑ Supporting documents Included <br /> Describe actions taken or will be taken to correct violation: <br /> q . ta t <br /> 4, <br /> Violation##605-Failed to completely label containers or portable tanks of hazardous waste. <br /> M This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken orwillbe taken to correct violation, <br /> Page 2of2 <br /> Rev.9116/2020 <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 />