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SAN J O A Q U I N Environmental Health Department <br /> i <br /> Corrective Action Statement <br /> RE:August 11 2020, 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 efloridoraslgov.org. <br /> Facility name: Ross Dress For Less#0477 Submit completed form to: <br /> Facility address: 340 W Kettleman Ln SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10508965 ATTN:ELIANNA FLORIDO <br /> PR0539585 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#104-No modified contingency plan. (� <br /> ❑ This violation was corrected OlThis violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> V <br /> Violation#105-No emergency coordinator. ,l <br /> ❑ This violation was corrected his violation will be corrected by(date): <br /> t <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#110-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 /> Page 2 of 3 <br /> ro19 <br /> 1868 E. Hazelton Avenue i Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 WwW,Sjcehd.Cnm <br />