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SAN JOAQUIN Environmental Health Department <br /> - - c:_ 0LJNTY - - <br /> Corrective Action Statement <br /> RE: October 04, 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 for <br /> with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please contact <br /> Robert Lopez at (209) 953-6214 or rlopez@sjgov.org . <br /> Facility name: MCDONALDS #6216 . . ,, - Submit completed form to:- <br /> Facility address: 1423 N CENTER ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180771 ATTN: ROBERT LOPEZ <br /> PR0520673 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> 1$ This violation was corrected ❑ This violation will be corrected by (date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will betaken to correct violation : ZZ . <br /> r <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: ffkLx ) : 11 <br /> Violation #9 - Failed to annually review and certify that the HMBP is complete and accurate by the due date . <br /> IN 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 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 I www.sigov.org/EHD <br />