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COMPLIANCE INFO_2022
EnvironmentalHealth
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1900 - Hazardous Materials Program
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PR0538675
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COMPLIANCE INFO_2022
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Last modified
9/12/2022 1:53:15 PM
Creation date
9/12/2022 1:50:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0538675
PE
1920
FACILITY_ID
FA0005035
FACILITY_NAME
WALGREENS #2961
STREET_NUMBER
75
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03704423
CURRENT_STATUS
01
SITE_LOCATION
75 N HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Environmental Health Department <br />Corrective Action Statement <br />RE: September 02, 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 <br />form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br />contact Garrett Backus at (209) 468-2986 or gbackus@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: GARRETT BACKUS <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to:WALGREENS #2961 <br />10181715 <br />75 N HAM LN <br />PR0538675 <br />Violation #6 - Failed to electronically submit a site map with all required content. <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: <br />Violation #9 - Failed to annually review and certify that the HMBP is complete and accurate by the due date. <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: <br />Violation #12 - Failed to have the HMBP readily available to facility or EHD personnel. <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: <br />Page 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />HMBP was corrected via CERS on 9/6/2022 <br />which includes an updated site map with location of LPG. <br />HMBP was corrected via CERS on 9/6/2022 <br />adding Liquified Propane Gas (LPG) the inventory and map as requested. <br />HMBP was corrected via CERS on 9/6/2022 <br />and a copy was sent to the store to be kept on file.
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