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SAN J O A Q U i N Environmental Health Department Corrective Action Statement RE: September 15, 2023, Hazardous Materials inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Paul Nso at (209) 616-3049 or pnso@sjgov.org. Facility name: KELLEYS EXPRESS CAR WASH Submit completed form to: Facility address: 100 E LODI AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT CERS ID: 10182311 ATTN: PAUL NSO PR0526527 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on site. r� This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: Violation #6 - Failed to electronically submit a site map with all required content. 0 This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included WkWMCCA- Describe actions taken or will be taken to correct violation: 1'1 t1 Di d �� 111UD �701S Y`ne'h SyilOM46 an C£-gS awd mos cl 00-- sire • Violation #9 - Failed to annually review and certify that the HMBP is complete and accurate by the due date. This violation was corrected ❑ This violation will be corrected by (date): Supporting documents included Describe actions taken or will be taken to correct violation: A fftier hdS been Sef ±32 tASWe a CC -RS A]kfa i i S cbm )eie 0,"%)Ai1 rf J - ii - A ab* the Ylk l-CwY is Glfmch Page 2 of 3 Rev. 9/16/2020 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD