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RECEIVED 02/05/2022 <br /> SAN _ OAQUIN Environmental Health Department <br /> C)L� N" Y <br /> Corrective Action Statement <br /> RE: January 05, 2022, 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 Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: VALLEY PACIFIC LODI PLANT&CARDLOCK Submit completed form to: <br /> Facility address: 930 E VICTOR RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181885 ATTN:VICKY VANG-LEE <br /> PR05 1'26FAR 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#108-Failed to complete,sign or date manifest;or obtain dated signature of transporter. <br /> 0 This violation was corrected ❑This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Found manifest and notified DTSC of error <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 /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Found manifest and notified DTSC of error <br /> Violation#111 -Failed to comply with uniform hazardous waste manifest exception requirements. <br /> El This violation was corrected ❑This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Found manifest and notified DTSC of error <br /> Page 2 of 3 <br /> Rev.9/16/2020 <br /> 1868 E.Hazelton Avenue C Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />