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! r j � nit I Environmental Health Department <br /> UU <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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: BURWOOD CEMETERY Submit completed form to: <br /> Facility address: 28320 E RIVER RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182605 ATTN: KRISTINA SAETERN <br /> PR0519558 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#11 -Failed to provide or document initial and/or refresher training to appropriate personnel. <br /> 53 This violation was corrected ❑This violation will be corrected by(date): <br /> G7/Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> ` LID. 4La LGln . <br /> 05 ►D tU r'ed C�-I` � + d oor s tJ D t H U <br /> Sf a-•�� <br /> C�r�z s Kees '> tzs <br /> - "re' arj <br /> Rev.911612020 Page 2 of 2 <br /> 1868 E. Hazelton Avenue 1 Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sigov.org/EHD <br />