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SAN J O A Q U I N Environmental Health Department <br /> couNt 7Y <br /> Corrective Action Statement <br /> RE: August 05 , 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 form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Haze Saeed at (209) 953-6212 or hsaeed@sjgov.org. <br /> Facility name: DELTA FARM PACKING Submit completed form to: <br /> Facility address: 111 N ZUCKERMAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10187715 ATTN : HAZA SAEED <br /> PR0536314 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation #4 - Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br /> PQ This violation was corrected DQ This violation will be corrected by (date): <br /> 8/11 /2021 <br /> jsj Supporting documents included <br /> Describe actions taken or will be taken to correct violation: The business Owner/Operator Identification <br /> form was updated on the CERS online database and the Primary Emergency Contact was updated <br /> Phil Cervantes was removed and Replaced with the new plant managers name Sandra Fregoso <br /> The application for a Hazardous Waste EPA # has been sent and will add number once received . <br /> Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> M This violation was corrected 14 This violation will be corrected by (date): 8/10/2021 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Hazardous materials Inventory has been <br /> updated on the CERS online database. Bleach , Propane , Diesel have been added and the chemical <br /> inventory was updated to the new and current chemical hazard classes/categories <br /> See: CERS online database . <br /> Violation #6 - Failed to electronically submit a site map with all required content. <br /> M This violation was corrected M This violation will be corrected by (date): 8/1012021 <br /> PQ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Site Map has been Updated . The propane <br /> tanks , the Potato Wash and the Chlorine cylinders locations have been added to show acurate <br /> locations . Seachlor and Kleaner Q5 have been removed . <br /> Page 2 of 4 <br /> Rev. 9/18/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/EHD <br />