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SA N J OA Q U I N Environmental Health Department <br /> -COUNTY <br /> Corrective Action Statement <br /> RE: August 05, 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: 1N N OUT BURGER#197 Submit completed form to: <br /> Facility address: 2625 W KETTLEMAN LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10185181 ATTN: ROBERT LOPEZ <br /> PR0526524 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#6-Failed to electronically submit a site map with all required content. / <br /> This violation was corrected _,121l his violation will be corrected by (date): <br /> ?--Supporting documents included { <br /> Describe actions taken or will be taken to correct violation: (ate '�1�(i'-e�C4— in m� C <br /> Violation #7 - Failed to electronically submit an adequate ER procedures for a release or threatened release. <br /> El This violation was corrected his violation will be corrected by (date): <br /> ,PY,Supporting documents included <br /> Describe actions taken or will be taken to correct violation: 5,tz -e-iC le1r�� <br /> Violation#11 - Failed to provide or document initial andlor refresher training to appropriate personnel. <br /> /E3 This violation was corrected la-fhls violation will be corrected by (date): <br /> Supporting documents included I <br /> Describe actions taken or will be taken to correct violation: t'� ��Gf�-d ry CA 06","'Ve" <br /> or <br /> Page 2 of 2 <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 />