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SAN <br /> J O A Q U N Environmental Health Department <br /> C 0U NTY <br /> Corrective Action Statement <br /> RE: October 29, 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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: ROBERT HOLMES Submit completed form to: <br /> Facility address: 16048 S SEXTON RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181175 ATTN: KRISTINA SAETERN <br /> PRO547307 1868 E HAZELTON AVENUE <br /> STOCKfON,CA 95205 <br /> Violation#406-Empty hazardous waste or material container greater than 5 gallons not managed per this <br /> section. <br /> JW This violation was corrected (This violation will be corrected by(date)_ —/3---40z--- <br /> be Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> '� �... ,� b/.s.�/�� 5 �O o,�,�v.�►5 �rJ...e. _4, sra 414 zv z-/ <br /> /s q,� .-s v %/ ����>•. ,cam s�� �-► �-16-zvz-/ <br /> �- s>s 9,a!-I/vim ,�/��- oPrv.n� c.��-I�i -F�j� e�� orad r�•��P u s <br /> Avr /ilill'r�3. <br /> Re?rn�n✓irvs f Irisi�rr. �1wm..� 9 -}-s�,�d1e •ri�✓se� � ��" �� f of- o�P�,r:`�/ <br /> Oen Ag P1o?eAe s Reeyde- P*y , s,,T. e, `4? eewwt5sfoovrll <br /> a-- 140" Cvvvy 1,*eV-A-P, ox/ /3- �oZz <br /> - Z 5-6 gild-01 --Z B 6 4v4 c, --aP✓e, -I-o e*-Wt pr <br /> bew' q �N v� le, +c+& L A-s ell,srh.L-14e-d, A/1 f <br /> h C-, tet r-e e-ye l eW /)f e, (, iH Tj PE 2-) we6 &OL vP I <br /> ems;ll 6C- 4 PIWAAe- Ree -le' 0ex, ct+ NO.-A <br /> Page 2 of 2 <br /> Rev.9116/2020 <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 />