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Environmental Health Department <br /> COU.N;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 bellow each violation. Submit this completed <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions,please <br /> contact Paul Nso at(209)616-3049 or pnso@sjgov_org. <br /> Facility name: DOES AUTO REPAIR Submit completed form to: <br /> Facility address: 469 MOFFAT BLVD STE C SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID_ 10187029 ATTN:PAUL NSO <br /> 1868 E HAZELTON AVENUE <br /> PRO528015 STOCKTON,CA 95205 <br /> Violation#4-Failed to electronically submit the Business Activities or OwnerlOperator Identification page. <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: <br /> ffp—)7M dommmh <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on site. <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_ .� <br /> LAI 0/ CJ! <br /> Violation#6-Failed to electronically submit a site map with all required content. <br /> ❑ This violation was corrected Q This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: ,Y <br /> tA'0- n� <br /> Page 2 of 3 <br /> Rev.9MM020 <br />