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SAN�IOAQUIN Environmental Health Department <br /> � �I COUNTY-- -- <br /> °.4 Greorness grows here. <br /> Corrective Action Statement <br /> RE: August 31, 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. <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 Shewit Woldearegay at(209)616-3063 or stwoldearegay@sjgov.org. <br /> Facility name: QUIK STOP MARKET#076 Submit completed form to: <br /> Facility address: 1030 S OLIVE AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180695 ATTN: SHEWIT WOLDEAREGAY <br /> PR0518566 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#110-Failed to keep signed copy of manifests from the designated facility for three years. <br /> 0 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 /> Missing manifest was located and sent to site to submit into the onsite binder. Future manifests will be <br /> kept in binder for the required time period. <br /> Violation#403-Failed to keep hazardous waste containers closed except when adding or removing <br /> hazardous waste. <br /> IN 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 /> Hazardous waste has been disposed of in this container. Future containers will remain closed when not <br /> adding or removing waste. Manifest attached. <br /> Page 2 of 3 <br /> Rev.9/16/2020 <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 />