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SAN J 0 A a U l N Environmental Health Department <br />Corrective Action Statement <br />RE: August 17, 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. <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 Vicky Vang-Lee at (209) 616-3028 or vvang-lee@sjgov.org. <br />Facility name: Verizon Business: KINGCA Submit completed form to: <br />Facility address: 13850 N DE VRIES RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10181479 ATTN: VICKY VANG-LEE <br />PRO511394 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <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 t ken or will^be taken correct violation: <br />t <br />Rev. 9/1612020 Page 2 of 2 <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 />