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S A N D AQ U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: September 20, 2023, 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 Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: Nutrien Ag Solutions-Vernalis Submit completed form to: <br /> Facility address: 35100 S HVVY 33 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182607 ATTN: VICKY VANG-LEE <br /> PR0519561 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#4-Failed to electronically submit the Business Activities or OwnerlOperator Identification page. <br /> 1W 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: pU Cr�ez� 'B\A SAne-SS 4 G� ,J4� aS <br /> Violation #5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> ❑ This violation was corrected gThis violation will be corrected by(date): C){ Z U 1 Z3 <br /> ❑ Supporting documents included <br /> Describe actions taken or wiil be taken to correct violation: <br /> Violation #6-Failed to electronically submit a site map with all required content. <br /> )S. This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included p <br /> Describe actions taken or will be taken to correct violation: 0\0 cam.s—e3 A e i. < i 0 <br /> Page 2 of 4 <br /> Rev 911612620 <br /> 1863 E Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 wvvw.sjgov.org/EHD <br />