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S A J O A O U, N Environmental Health Department <br /> Corrective Action Statement <br /> RE: January 13, 2020, Hazardous Waste 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 /> Elianna Florido at(209)468-0343 or eflorido@sjgov.org. <br /> Facility name: PEP BOYS#711 Submit completed form to: <br /> Facility address: 4987 WEST LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181553 ATTN: ELIANNA FLORIDO <br /> PR0513935 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#113-Failed to send generator manifest copies to DTSC within 30 days. <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: 3, /vl.5 5,!2:% <br /> ® P5C <br /> 7 /,DrZ. g_ fcs ,fre { <br /> - <br /> � ,�te.ra4��t fmait s <br /> Violation#114-Failed to keep signed copy of manifests from the designated facility for three years. <br /> )A 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 /> 44a: S L �-�p !_l�C ✓1 fest 1� l/ <br /> „> L4 <br /> Violation#115-Failed to comply with uniform hazardous waste manifest exception requirements. <br /> ❑ This violation was corrected AThis violation will be corrected by(date): 2) �� f <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> F}lI POU-3 t5 rP �rLSG'nd c�r��lii �{.rs usr Sv <br /> r r <br /> F L E /LN C � v� F? i�vr„l ,fit S,IP� c irla v".��✓" <br /> Page 2 of 5 <br /> Rev.8/27/2019 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd-corn <br />