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lowQ 0QQ Envoronment; ► I Health Department <br /> C' <br /> Y <br /> • , <br /> Corrective Action Statement <br /> RE , June 14, 2022 , Hazardous Materials inspection report <br /> For each violation listed below, indicate If the violation has been corrected or will be corrected b+r a certain date, Also , <br /> describe what was done to correct the violation in the space provided below each violation . Sukimit this completed <br /> form with the Return to 'Compllance Certification within 30 days of Inspection . If you have any questions , please <br /> contact Carol Presto at (209) 616-3061 or cpresto@sjgov. org . <br /> J <br /> Facility name : TIWANA GAS & FOOD Submit completed form to: <br /> Facility address: 1210 E HAMMER LN SJC ENVIRONMEN "AL HEALTH DEPARTMENT <br /> CERS ID : 10181355 ATTN : CAROL PRE>TO <br /> PRO519415 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #5 on Failed to electronically submit hazardous materials inventory for all reportable materials on site. <br /> Fir/ This violation was corrected 13 This violation will be corrected by (date),, <br /> © Supporting documents Includod tt <br /> Describe actions taken or will be taken to correct violation : n ) 40 , <br /> Obi <br /> Violation #7 - Failed to electronically submit an adequate ER procedures for a release or threatened release. <br /> IR/This violation was corrected 0 This violation will be corrected by (date) : <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation : f� 6 l �r � gG One <br /> o G� S <br /> Page 2 of 2 <br /> Roy. 8/102020 - <br /> 1866 E , Hazelton Avenue l Stockton , California 95205 l T 2.09 468-3420 ( F 209 464-G138 l www, sjgov. org/EHD <br /> Received Time Jun , 29 . 2022 3 : 03PM No , 7250 <br />