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Environmental health Department <br /> S A N3WIN <br /> Corrective Action Statement <br /> RE: January 19, 2922, 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 /> PR0547307 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#3010-Unlisted Administration/Documentation violation. <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: n <br /> T <br /> 5 -T C. P, 4, L,]�, ,,✓v ,��cr�f /vim S <br /> Page 2 of 2 <br /> Rev.9!1612620 <br /> 1868 E. Hazelton Avenue € Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 wwvr.sjgov.arg/EHD <br />