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SAN JOAQUIN Environmental Health Department <br /> Corrective Action Statement <br /> RE September 09. 2019, Hazardous Waste inspection report <br /> For each violation listed below. indicate if the violation has been corrected or vall 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 for <br /> with the Realm to Compliance Certification with,30 days of inspection, 11 you have any questions. please contact <br /> Cesar Ruvalcaba at 1209)953-6213 or tmvalcabaQsjgov org. <br /> Facility name: CONEY ISLAND FARMS INC-HOME RANCH Submit completed form to: <br /> FaNrty address. 19500 CLIFTON COURT RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10185643 ATTN:CESAR RUVALCA79A <br /> PRO530955 1868 E HAZELTON AVENUE <br /> STOCKTON. CA 95205 <br /> Violation 4101 - klanaged a hazardous waste without an Identification number. <br /> tSu2' Is violation was connected 11 This violation will be corrected by(date): <br /> pporting documents included <br /> Describe actions Iekcn a will be taken to torted violation. <br /> NeF�J�cdeoC gip/} l'ai%SfrV - .se£ a1�G� " i r �a '�✓� �1un+G2p� <br /> ii�tlsmath [ol�� <br /> Violation <br /> #113 -Failed to keep copies of consolidated manifesting receipts for three years, <br /> aonThis viol tion was..Ratted Cl This violation will be corrected by(date). <br /> 0"'itupporting documents included <br /> Descnbe achorrz taken Or will be take.to.correct v�antYm <br /> .L Loa( <br /> inlo(ceo �oinavkf LoW r 2uPli75 <br /> un ammo <br /> Page 2 of 2 <br /> 1868 E.H1170011 Avenue 1 Stockton.California 95205 1 T 209 468-34201 F 209 464-0 138 1 wwwsjcehd.com <br />