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SAN J OAQ U I N Environmental Health Department <br />COU NTY- <br />Corrective Action Statement <br />RE: April 08, 2021, 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 />Elena Manzo at (209) 953-7699 or emanzo@sjgov.org. <br />Facility name: RON MENCARINI &SON <br />Facility address: 20575 N DE VRIES RD <br />,ERS ID: 10831801 <br />PRO545365 <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATFN: ELENA MANZO <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #4 -Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br />/��This violation was corrected <br />UDDortina documents included <br />❑ This violation will be corrected by (date): <br />Violation #5 -Failed to electronically submit hazardous materials inventory for all reportable materials on <br />site. <br />❑ This violation was corrected <br />❑ Supporting documents included <br />❑ This violation will be corrected by (date): <br />Describe actions taken or will be taken to correct violation: <br />Violation #6 -Failed to electronically submit a site map with all required content. <br />This violation was corrected <br />Supporting documents included <br />❑ This violation will be corrected by <br />Describe actions taken or will be taken to correct violation: <br />Page 2 of 4 <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 />