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SAN J QA Q U I N Environmental Health Department CC>UNTY Corrective Action Statement RE: October 02, 2020, Hazardous Materials inspection report For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, describe what was done to correct the violation in the space provided below each violation. Submit this completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact Robert Lopez at(209)953-6214 or rlopez@sjgov.org. Facility name: GOLDEN STATE LUMBER INC Submit completed form to: Facility address: 3033 S Airport Way SJC ENVIRONMENTAL HEALTH DEPARTMENT CERS ID: 10184971 ATTN: ROBERT LOPEZ PRO522809 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Violation#4-Failed to electronically submit the Business Activities or Owner/Operator Identification page. [' This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe rt actions taken or will betaken to correct violation: Yl rA L�it r� ✓ /L rJ[. c,`U1^ r`A(Arn,,, S Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on site. (2 This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will betaken to correct violation: Veos-jgj I ny,-n-6r:x C". A G� rc rb+1� 4h� � .r sccbr„f erA. Violation #6 - Failed to electronically submit a site map with all required content. This violation was corrected ❑ This violation will be corrected by (date): ❑ Supporting documents included Describe actions taken or will be taken to correct violation: 5 -c- r'-1c, an IC c-. r• G 6nt, Page 2 of 4 Rev,9/1612020 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD