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SO JOANIN <br /> Environmental 4ealth Department <br /> ,, <br /> I <br /> Corrective Action Statement <br /> RE: October,21, 2020, Hazardous Materials inspection repo <br /> For eac, violation isted below, indicate if t e violation has been corrected or will be corrected by a ertain date. Also, <br /> describd what wasdone to correct the viol tion in the space provided below each violation. Submit his completed <br /> form with the Retu n to Compliance Certification within 30 days of inspection. If you have any quest ons, please <br /> contact arol Pre oat(209)616-3061 ori presto@sjgov.org. <br /> Facility ame: SHORT STOP FOOD ART Submit completed form t(: <br /> Facility LIdress: 20 W TURNER RD#�h SJC ENVIRONMENTAL EALTH DEPARTMENT <br /> CERS 1©: 10180633 ATTN: CAROL PRESTO <br /> PRO520474 1868 E HAZELTON AVE UE <br /> STOCKTO�,N, CA 95205 <br /> Violation#5-Failed to electronically subi nit hazardous materials inventory for all reportable nic terials on site. <br /> M/This viola ion was corrected ❑This violation will be corrected,by(date): <br /> © Supporti g documents included <br /> Describe actio is taken or will be taken to correct violation: Y � S <br /> M&Af--V-1CJ1 V G CL 1'1' <br /> Violation#6-Fail d to electronically submit a site map with all required content. <br /> 9/This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ $upporting documents included <br /> Describe actions taken or will be taken o correct violation: , <br /> i A [ <br /> Violation#9-Failei to annually review ari certify that the HMBP is complete and accurate by th a due date. <br /> 151"'lihis violat on was corrected ©This violation will be corrected by(date): <br /> ❑ <br /> �upporting documents included <br /> Describe action taken or will be taken W correct violation: <br /> 0—sm, JW MOCAA-) <br /> Page 2 of 3 <br /> Rev.914612020 <br /> 1868 E. Hazelt n Avenue I Stockton, Lalifornia 95205 1 T 209 468-3420 f F 209 464-0138 1 fvww.sjgov.org/EHD <br />