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SAN J OAQ U I N Environmental Health Department <br /> C J I%1TY <br /> Corrective Action Statement <br /> RE: January 14, 2021, 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. <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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: DEL TACO(HAMMER) Submit completed form to: <br /> Facility address: 817 W HAMMER LN SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10184301 ATTN: KRISTINA SAETERN <br /> PRO521207 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> / <br /> IrJ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken orwill be taken to correct violation: The kaznrd.aoa w,d-knnl tro'e maj <br /> Tbvvn .moo[ c mplelmd cumA yhtoo. r-A on webc�-)c <br /> Violation#7-Failed to electronically submit an adequate ER procedures for a release or threatened release. <br /> ii 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: enlenzci 4-kr lrylissinq to co;: on on <br /> +Wt Frim,94--neg Peirlomse Plnn Cec}ion 6 Res hrii4d no CRC WrbStle <br /> Page 2 of 2 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205) T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />