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;AN <br />OJ OQ Q U I N Environmental Health Department <br />Corrective Action Statement <br />RE: August 10, 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 />Vicky Vang-Lee at (209) 616-3028 or vvang-lee@sjgov.org. <br />Facility name: SPACERAK Submit completed form to: <br />Facility address: 214 S KELLY ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />'ERS ID:10183299 ATTN: VICKY VANG-LEE <br />PR0520126 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #6 -Failed to electronically submit a site map with all required content. <br />J� This violation was corrected ❑This violation will be corrected by (date): <br />k supporting documents included p <br />Describe actions taken or will be taken to correct violation: <br />Qoo. p` -ri k"' jMgV r'1e'i:) <br />Violation #9 -Failed to annually review and certify that the HMBP is complete and accurate by the due date. <br />This violation was corrected El This <br />violation will be corrected by (date): <br />Supporting documents included <br />Describe actions taken or will be taken to correct violation: 1 �- � e'c �'�°�A <br />S�q'kAA n" c loc"Ae- y <br />Violation #11 -Failed to provide or document initial and/or refresher training to appropriate personnel. <br />This violation was corrected <br />�— Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: C"1�-S t. SGS-' <br />SueP��}In; ds.�cc,me.�,� <br />Page 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 i F 209 464-0138 � vrww.sjgov.org/EHD <br />