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S AN J O A Q U I N Environmental Health Department <br />Corrective Action Statement <br />RE: October 11, 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 Claudia Muro at (209) 468-3429 or cmuro@sjgov.org. <br />Facility name: BUTTER GOULD Submit completed form to: <br />Facility address: 2505 W HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10186823 ATTN: CLAUDIA MURO <br />PRO541406 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #101 - Managed a hazardous waste without an identification number. <br />✓� This violation was corrected ❑This violation will be corrected by (date): <br />Q Supporting documents included <br />Describe actions taken or will be taken to correct violation: <br />SVMF has applied for a <br />ID# CAR000301663 has been issued. <br />Violation da:104 - No modified contingency plan. <br />federal EPA# and <br />This violation was corrected ❑This violation will be corrected by (date): <br />[j Supporting documents included <br />Describe actions taken or will be taken to correct violation: Contingency plan has been updated and posted <br />at the facility. (See attached copy of updated plan) <br />Violation df105 - No emergency coordinator. <br />LY!' This violation was corrected <br />l�Supporting documents included <br />❑ This violation will be corrected by (date): <br />escribe actions taken or will be taken to <br />Dcorrect violation: Contingency plan has been updated and posted <br />at the facility. (See attached copy of updated plan and emergency coordinator contact information) <br />Page 2 of 4 <br />Rev. 8!27!2019 <br />1II68 E. I-lazelton Avenue I Stockton, California 95205 i T 209 468-3420 i F 209 464-0138 i www.sjcehd.com <br />