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f El. E Y L <br /> SAN =JOAQUINEnvironmental Health Department <br /> CQW\ITv 5EP 1 5 102"r <br /> II [ AI1 'rl <br /> m I <br /> Corrective Action Statement <br /> RE: July 21, 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. <br /> Also, describe what was done to correct the violation in the space provided below each violation . Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection . If you have any questions, <br /> please contact Robert Lopez at (209) 953-6214 or rlopez@sjgov. org . <br /> Facility name: BT Industrial Services Submit completed form to: <br /> Facility address : 941 S PILGRIM ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10183413 ATTN: ROBERT LOPEZ <br /> PR0512580 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation 94 - Failed to electronically submit the Business Activities or Owner/Operator Identification page . <br /> ❑ This violation was corrected XThis violation will be corrected by (date) : ( V i Aon <br /> ❑ Supporting documents included <br /> Describe actions taken or wit bq taken to correct violation g 1�CfJ WY\ VS Y)b � QY\(� Q,Y— <br /> A rev lm !5 \IIY��chNje �1 o tail <br /> � 5 oYN G aylQ. fir% n4, ( o.,r ko reArv �rn A�kmFk <br /> k (L les: in WY) a'r . <br /> Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site, l <br /> ❑ This violation was corrected b{l This violation will be corrected by (date): 101 3i Iaoae)' <br /> ❑ Supporting documents included l{, <br /> Describe actions taken or will be taken to correct violation : ` `Uh l 6 b kyv <br /> — re <br /> Violation #6 - Failed to electronically submit a site map with all required content. 1 <br /> ❑ This violation was corrected M This violation will be corrected by (date ): <br /> ❑ Supporting documents included /t 1 <br /> Des r be action taken or ill be taken to correct violation: -d ca\01 `/ <br /> vs � Yq \ eyy\w <br /> Page 2 of 4 <br /> Rev. 9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www. sjgov. org/EHD <br />