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SAN J O A Q U I N Environmental Health Department <br />TY <br />Corrective Action Statement <br />RE: November 20, 2019, RCRA 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 form <br />with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br />Elianna Florido at (209) 468-0343 or eflorido@sigov.orq. <br />Facility name: Banfield Pet Hospital #1188 Submit completed form to: <br />Facility address: 10520 Trinity Pkwy SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />CERS ID: 10643443 ATTN: ELIANNA FLORIDO <br />PR0542389 1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Violation #108 - Failed to prepare and implement a 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 #115 - Failed to keep signed copy of manifests from the designated facility for three 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 #116 - Failed to comply with uniform hazardous waste manifest exception requirements. <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 2 of 4 <br />Rev. 8/2712019 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />