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SAN J OA Q U I N 1 r�uvo �r �� naillonina 6lo c-� c� �1 � � G1 c� e ��� � o° � r��o � �u � <br /> { II ' i . ij (. Ii . .. 1 ilio „ � Ip7fr' 1 <br /> Corrective Action Statement <br /> RE : October 29 , 2020 , Hazardous Materials 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 Paul Nso at (209 ) 616 -3049 or pnso@sjgov . org . <br /> Facility name : RAMOS OIL- FRENCH CAMP Submit completed form to: <br /> Facility address : 10842 S HARLAN RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10182151 ATTN: PAUL NSO <br /> PR0520397 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #4 - Failed to electronically submit the Business Activities or Owner/Operator Identification page . <br /> PT 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 : tQ. a Pel j )1 f U CCI? S n p) A t4 hclG fet' <br /> Violation #5 - Failed to electronically submit hazardous materials inventory for all reportable materials on site <br /> 1711�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 : Ly aetk 1 )l f0 6 F-95 C< 11A L4 Pde4eA <br /> & 7/AjcAoNS MA+er14 k rc�Yl �vyy <br /> Violation #6 - Failed to electronically submit a site map with all required content , <br /> I�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 : L4E& C> d 6lick 140704 61 e(t Sire AJ4 a <br /> z <br /> Page 2 of 4 <br /> Rev. 9/1612020 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468-3420 1 F 209 464 -0138 1 www . sjgov . org/ EHD <br />