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S A N JO A Q U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: May 10, 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 Eliaiina i`IOridO at(21091) i v-.ryi 05v or$fiorido@Si °1 yu .t'ir�i�.j. <br /> Facility name: ARCO AM/PM Submit completed form to: <br /> Facility address: 3443 CHEROKEE RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10830655 ATTN: ELIANNA FLORIDO <br /> PRO545107 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#2-Failed to initially complete and electronically submit a i-iMBP. <br /> ® This violation was corrected ❑This violation will be corrected by(date): <br /> ED Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Submitted CERS <br /> Violation#3-Failed to establish and implement a hazardous materials business plan. <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 /> Submitted CERS <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> dC 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 /> Q1 ihrnitfF H <br /> IJ Li LJ4111 LL4U 1J L!\ll <br /> Page 2 of 4 <br /> Rev.9118/2020 <br /> 1$65 E, Haaelton Avenue i Stockton, California 952U5 1 T 209465-3420 1 F 209464-0138 1 www.s(gov.orgiEHO <br />