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SAN 10AQUIN <br />Environmental Health Department <br />Corrective Action Statement <br />RE: August 14, 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. <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 Elianna Florido at (209) 468-0343 or eflorido@sjgov.org. <br />Submit completed form to: <br />Facility name: Dollar General #14661 SJC ENVIRONMENTAL HEALTH <br />Facility address: 1940 McHenry Ave DEPARTMENT <br />CERS ID: 10625803 ATTN: ELIANNA FLORIDO <br />1868 E HAZELTON AVENUE <br />PR0540012 <br />Violation #103 - Failed to retain hazardous waste determination including waste analysis on site for 3 years. <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 #104 - No modified contingency plan. <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 #106 - Failed to train employees on waste handling and emergency procedures. <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 1 of 2 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />