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SAN :-JOAQUIN <br /> Environmental Health Department <br /> �._. ,C 0 U �%,i Y __:..__. <br /> Greoiness qts -v here. <br /> with the Return to Compliance Certification within 30 days of inspection. if you have any questions, please contact <br /> Haza Saeed at(209) 953-6212 or hsaeed@sjgov.org. <br /> Facility name: MOUNTAIN HOUSE CSD WATER TREATMENT Submit completed form to: <br /> Facility address: 18045 S KELSO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184631 ATTN: HAZA SAEED <br /> PR0519259 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <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 /> The 45 gallons of polymer was added to the hazardous <br /> materials inventory on 11-2-2021 <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): December 31,2021 <br /> F1 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Will update and submit an updated map by December 31 2021 <br /> Page 2of3 <br /> Rev.9/16/2020 <br />