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SAN J O A Q U I N Environmental Health Department <br /> - r% i TY <br /> Corrective Action Statement <br /> RE : November 13 , 2019 , 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 efloridoasjgov. org . <br /> Facility name : Petco Store # 1291 Submit completed form to : <br /> Facility address : 2350 W KETTLEMAN LN # 120 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10741306 ATTN : ELIANNA FLORIDO <br /> PR0542084 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #101 - Managed a hazardous waste without an identification number. <br /> II This violation was corrected ® This violation will be corrected by (date) : 5 . 15 . 2020 <br /> [I Supporting documents included <br /> Describe actions taken or will be taken to correct violation : Emailed reactivation form to DTSC as I am unclear <br /> to why number was made inactive to begin with . I have attached completed form <br /> Violation #110 - Failed to keep signed copy of manifests from the designated facility for three years . <br /> [I This violation was corrected ® This violation will be corrected by ( date) : 12 . 1 . 2019 <br /> [2 Supporting documents included <br /> Describe actions taken or will be taken to correct violation : Manifests were emailed to store and I have <br /> attached copies for you <br /> Violation #111 - Failed to comply with uniform hazardous waste manifest exception requirements . <br /> This violation was corrected ® This violation will be corrected by ( date) : 12 . 1 . 2019 <br /> ij Supporting documents included <br /> Describe actions taken or will be taken to correct violation : Manifests were emailed to the store and I have <br /> attached copies for you. <br /> Page 2 of 3 <br /> Rev. 8/27/2019 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 T 209 468-3420 1 F 209 464-0138 1 www. sjcehd . com <br />