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Jc A NPJ0A04 U I N Environmental Health Department <br /> A1� it <br /> —COUNTY--- <br /> Greatness grows here. <br /> Corrective Action Statement <br /> RE: August 10, 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 Nicholas Loehrer at(209)468-0623 or nloehrerp_sjgov.org. <br /> Facility name: FIREWORKS AMERICA TRACY Submit completed form to: <br /> Facility address: 32727 S CORRAL HOLLOW SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10729381 ATTN: NICHOLAS LOEHRER <br /> PRO512097 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#4-Failed to complete and/or submit the Business Activities or Owner/Operator Identification <br /> page. <br /> V This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> c 1 <br /> Describe actions taken`or�will be taken to correct violation: )1_7A311`U�1 OW� <br /> Violation#5-Failed to complete and/or submit hazardous materials inventory for all reportable materials on <br /> site. <br /> V( This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> c• I <br /> Describe actions taken or will be taken to correct violation: JJ'b'm i.A A�_ 01"-'\ <br /> Page 2 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 />