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SAN <br /> J O A Q I U i I N Environmental Health Department <br /> .- IY IV <br /> —COU NTY <br /> ,F <br /> Corrective Action Statement <br /> RE: June 21, 2024, 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 /> Maria Lopez at(209)616-3064 or melopez@sjgov.org. <br /> Facility name: FORWARD INC LANDFILL Submit completed form to: <br /> Facility address: 9999 S AUSTIN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182195 ATTN: MARIA LOPEZ <br /> PR0515721 1868 E HAZE LTO N AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#3-4030038-SPCC has been implemented. <br /> IS] This violation was corrected ❑ This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: The SP001 inspection forms for monthly tank <br /> inspections has replaced all prior forms used for this task. The SP001 monthly inspection forms comply with <br /> the language in the most recent SPCC Plan. Training and review of requirements provided by PE and <br /> SP001 inspector(see attached training attendance form). <br /> Violation#51 -4030006-Rainwater in diked areas is inspected before draining. <br /> IS] This violation was corrected ❑This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Training and review of requirements with staff <br /> responsible for the diked tank storage area. Rainwater accumulated in the diked area is to be inspected before <br /> being discharged from the diked areas. The bypass valves will be normally closed and re-closed (sealed) <br /> following drainage under responsible supervision. Training and review of requirements provided by PE and <br /> SP001 inspector(see attached training attendance form). <br /> Violation#52-4010026-Records maintained of drainage from diked areas. <br /> IS] This violation was corrected ❑This violation will be corrected by(date): <br /> 0 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Documentation on inspection forms will be provided for <br /> drainage from any diked facility areas. Training and review of requirements provided by PE and SP001 Inspector. <br /> (see attached training attendance form). <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 1 www.sjgov.org/EHD <br />