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Y <br /> (j, ones 9rww3. here, <br /> Corrective Action Statement <br /> RE: May 1O. 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 toCompliance Certification within 30days ofinspection. |fyou have any questions, please contact <br /> Stacy Rivera at orarivara@oipov.ong. <br /> Facility name: JAMARGERV|CE Submit completed form to: <br /> Facility address: 4U75EMAIN 8T GJCENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS |D: 10180873 /QTN: STACYR|VERA <br /> PRU519738 18S8EHAZELTONAVENUE <br /> GT0CKTON. CA952O5 <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> Sd Thievio|ot|onwaacorvuctwd 13 This violation will be corrected by<dnte : <br /> OO Supporting documents included <br /> Describe actions taken orwill betaken tocorrect violation: <br /> Violation#6-Failed to electronically submit a site map with all required content. <br /> 96 This violation was corrected []This violation will be corrected by(date): <br /> OO Supporting documents included <br /> Describe actions taken orwill betaken tocorrect violation: <br /> Page 2of4 <br /> Rev.8/27/2019 <br />