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SAN J OAQ U I N Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here <br /> Corrective Action Statement <br /> RE: September 10, 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 <br /> form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please <br /> contact Christine Lawrence at(209)468-3562 or clawrence@sjgov.org. <br /> Facility name: MID VALLEY AGRICULTURAL SERVICES, INC Submit completed form to: <br /> Facility address: 16401 E HWY 26 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10396426 ATTN: CHRISTINE LAWRENCE <br /> PR0528829 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#109-Failed to send generator manifest copies to DTSC within 30 days. <br /> Id 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 /> M1kl C7PIt=.S of ISA-1.itFEST Feom Zc71'+ Artgr, Zoi5 -ro 1YTSC_ otrj <br /> 5E4-r. I ZI W►9 . l��cru.Lrr� A ram M r.Lt r�SY oN A6C'Tv;5ee Z .?Qcq Argo <br /> I M tA—"�i1>x t�t/a Ic.rr� <br /> COP',( Tb V11L-L. CCg'r 1y'-1Ur -r7 its T>1Z/n'.C'-n C' <br /> I►� �� rt_4-1-t�1CL E. <br /> Violation#110-Failed to keep signed copy of manifests from the designated facility for three years. <br /> IA This violation was corrected ❑This violation will be corrected by(date): <br /> I9 Supporting documents included <br /> Describe actions taken or will be taken to correct violation: CRTArItJfclJ CDPIrS CC- SICY�Irr�() <br /> FAA-h wfeGSTS fpµ 17GSLGn1.4'i`Q� t'AG��.t��C �2a1'� ��^^__Mh1.LtC- STS, n ►.low <br /> I--t/�'1� ON . <br /> rIl.{G. DP'f 1NACu.ut�rcn WiT�T"r% ZemitT . �.p%'?_.a t.1YZn MA-rL_rolS <br /> Abnczkss w t Trzq-els -�rJt �D r,�sucr.E D�l.i�1 Hof r�cAr.11--rsTs rr.► w.Turlr. <br /> Ii V^QSPOW Z Hfh- 7 INLCOZ->uvt MM�,i Nc, Ap412 rc5 S <br /> Violation#111 -Failed to comply with uniform hazardous waste manifest exception requirements. <br /> bt This violation was corrected ❑This violation will be corrected by(date): <br /> IZ Supporting documents included t <br /> Describe actions taken or will be taken to correct violation: 'SM41L C0ogr, Q AGToN Arsy 10t..A-IMN <br /> Page 2 of 4 <br /> Rev.8272019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />