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SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: January 05, 2022, Hazardous Materials inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be correated by a wrtain 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 vvitlun 30 days of inspection. If you have any questions <br /> pleasc contact Kristina Saetern at(209)616-3045 or ksaelern@slgov.org. <br /> Facility name. RIPON SHELL' Submit completed form to: <br /> Facday address= 341 E MAIN ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID.: 10181381 ATTN-. KRISTINA SAETERN <br /> PR0519348 1868 E i-iAZELTn'N AVENUE <br /> STOCKTON, CA 55205 <br /> Violation#5-Failed to electronically submit hazardous i"teriats inventory for all reportable materials on <br /> site. <br /> 21 Thts violation was corrected El This violation will be corrected by(date): <br /> 0 Supporting documents inchided <br /> Describe actions taken or will be taken to correcf violation: <br /> Violation#6-Failed to electronically submit a site map with all required content. <br /> [k,-T is violation was corrected El This violationwill be corrected by(date): <br /> © Supporting documents inctEided <br /> Degcnhe actions taken or will be taken lis r;nrrert virrtation: �. <br /> L <br /> Uralatio #T- ailed to electronically submit an adequate ER procedures for a release or threatened release. <br /> ❑ This violation was corrected 0 This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will he mken in cnrro.1 viniatinn. <br /> Page 2 of 2 <br /> 1 iii' E. tlazFl?uir Avenue 1 Slat:tvn L alItOh113 95205 1 T _1+19 468-542jU I F 209 I4;1-41T38 t Nuw.Slt;u..�r_;EF ('• <br />