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� �"""• � SANJOAQUIN Environmental Health Department <br /> COUNTY— <br /> T �r, �af2otnes� �fOwS +1QlC. <br /> Corrective Action Statement <br /> RE: July 08, 2020, 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. <br /> Also, describe what was done to correct the violation in the space provided below each violation. Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br /> please contact Robert Lopez at (209) 953-6214 or rlopez@sjgov.org. <br /> Jacobsen Pacific Ag,2187 N WILSON WAY, CERS IQ 10749190, PR0542321 <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 /> Violation #7 - Failed to establish and/or submit emergency response procedures for a release or threatened <br /> release. <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 3 of 4 <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 />