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SAN J O A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: October 22, 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 Christine Lawrence at(209)468-3562 or clawrence@sjgov.org. <br /> Facility name: AMERICAN MODULAR SYSTEMS Submit completed form to: <br /> Facility address: 787 SPRECKELS AVE SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184691 ATTN: CHRISTINE LAWRENCE <br /> PR0544250 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#102-Failed to determine if a waste is a hazardous waste. <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 /> U ' CCA "t t✓ O Lk- D ✓\ l S / and 9V/),100D-4 <br /> �1 U)0sLt;- � Z 61e�CM,'11101 /f ,-A-' d/Al Lt)C' <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: ��c�rcT C U( /Loi <br /> O /41 c-✓L / Com✓Cf <br /> d <br /> ;C L t e n <br /> 01,5 u ri <br /> �-> ►' (r �o <br /> Violation#113-Failed to keep copies of consolidated manifesting receipts 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: K�o n / l/G i v' <br /> t C c 6-42 i L 3 L <br /> I <br /> Coq Vcp� 5 �.4r, J2rr; �� , cl Gc� [� � 1 n{ 1 ��✓iG� ;�1�� ✓ c�c�/ <br /> 260 <br /> Page 2 of 4 <br /> Rev.6/27/2019 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />