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SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: August 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 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 /> Facility name: CARLS JR 1575 Submit completed form to: <br /> Facility address: 1489 Hulsey Way SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10637158 ATTN: NICHOLAS LOEHRER <br /> PR0540261 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#9-Failed to annually review and certify that the HMBP is complete and accurate by the due date. <br /> E7 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: "1V_ <br /> Violation#11 •Failed to provide or document initial andlor refresher training to appropriate personnel. <br /> 72/ 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#12-Failed to have the HMBP readily available to facility or EHD personnel. <br /> at 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 2 of 2 <br /> Rev W1612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209468-3420 1 F 209464-0138 1 www.sjgov.org/EHD <br />