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S Q N J O Q n U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: July 20, 2022, Hazardous Waste 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 /> Haza Saeed at(209)953-6212 or hsaeed@sjgov.org. <br /> Facility name: JACOBS MALCOLM&BURTT Submit completed form to: <br /> Facility address: 645 N STOCKTON ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10183563 ATTN: HAZA SAEED <br /> PRO540586 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#104-No modified contingency plan. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> -M'-Supporting documents included 11 <br /> Describe actions taken or will be taken to correct violation: 1*4%4et �T;7(Q„\, ets+c j <br /> '4 alsa c,*W. <br /> Violation#113-Failed to keep copies of consolidated manifesting receipts for three years. <br /> FThis violation was corrected ❑This violation will be corrected by(date): <br /> AEr Supporting documents included <br /> Describe actions taken or will be taken to correct violation: LdA v` i olokt^ ce ics g Aeiigfccs�d��_ <br /> KPer lhtn Malrrw -6w,,d. A-ft'acW cs Masi- Ye<-"4 <br /> Violation#601 -Stored hazardous waste onsite greater than 180 days(90 days acute I extremely). <br /> 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: }IQZ414-s L26Fe V,,* W., <br /> C,und--eve 19 Oro 4.0 On a eO rn&lfh 6rs. <br /> Page 2 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 />