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RECEIVED VIA EMAIL ON 03-29-2022 <br /> S A 10 A Q N IN Environmental Health Department <br /> C 0 t._j NJ T Y <br /> Corrective Action Statement <br /> RE: March 03, 2022, Hazardous Materials inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection, If you have any questions, please contact <br /> Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: KWIK SERV LODI BW 113* Submit completed farm to: <br /> Facility address: 420 W KETTLEMAN LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181407 ATTN:VICKY VANG-LEE <br /> PR0520807 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. ] i <br /> It This violation was corrected ❑This violation will be corrected by(date): JI 2J+ ZOz;Z <br /> © Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> to c L <br /> Violation#6-Failed to electronically submit a site map with all required content. I <br /> FL This violation was corrected aThis violation will be corrected by(date): �Z'c'-{ zC);_7 Z— <br /> © Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> �4.,c_ e•1cac��. C1G:e� .�:u se S Ic- i (—c{ "-i <br /> t>OfNi xe . Gil c�4-�-e� � .� �l�r.cx ��n �e�4,,.A_ <br /> Page 2 of 3 <br /> Rev.911612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www,sjgov.org/EHD <br />