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SAN J O A Q U I N Environmental Health Department <br /> r; - CQUNTY-- <br /> C Greatness gr�ow5 Frere. <br /> Corrective Action Statement <br /> RE: October 25, 2019, 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 <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Nicholas Loehrer at(209)468-0623 or nloehrer@sjgov.org. <br /> Facility name: 76 EXPRESS TIGER NO 1 Submit completed form to: <br /> Facility address: 5777 S FRENCH CAMP RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10182157 ATTN: NICHOLAS LOEHRER <br /> PR0520766 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#5-Failed to complete and/or submit hazardous materials inventory for all reportable materials on <br /> site. <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: <br /> Violation#6-Failed to complete and/or 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: <br /> Page 2 of 3 <br /> Rev.8/27/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />