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SNAOUIN Environmental Health Department <br />_-. .... COUP_. <br />Corrective Action Statement <br />RE: May 06, 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 />Nicholas Loehrer at (209) 468-0623 or nloehrer@sjgov.org. <br />BLACK BEAR DINER - LODI, 2347 W KETTLEMAN LN, CERS ID: 10711564, PR0535248 <br />Violation #10 - Failed to electronically update the HMBP within 30 days of substantial change in operations. <br />0 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 />Violation #11 - Failed to provide or document initial and/or refresher training to appropriate personnel. <br />❑ This violation was corrected GIThis violation will be corrected by (date): <br />5 f 2_7 12- 7- <br />❑ Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />Violation #12 - Failed to have the HMBP readily available to facility or EHD personnel. <br />2( 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 />Page 3 of 3 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />