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��Q IN Environmental HealthDepartment <br /> SANCorrective Action Statement <br /> RE: April 26, 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. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed for <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Robert Lopez at(209) 953-6214 or rlopez@sjgov.org. <br /> Facility name: HORIZON OXYGEN & MEDICAL EQUIPMENT Submit completed form to: <br /> Facility address: 4079 CALLOWAY CT SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: none ATTN: ROBERT LOPEZ <br /> PR0546823 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#2-Failed to initially complete and electronically submit a HMBP. <br /> This violation was corrected XThis violation will be corrected by (date): May 27, 2021 <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: The HMBP was submitted via CERS. <br /> A Copy has been attached. <br /> i <br /> i <br /> Violation#3-Failed to establish and implement a hazardous materials business plan. <br /> Xp� 4 <br /> This violation was corrected XThis violation will be corrected by (date): May 27,2021 <br /> X supporting documents included <br /> Describe actions taken or will betaken to correct violation: <br /> The HMBP has been completed and submitted via CERS. <br /> A copy has been attached. <br /> is <br /> h <br /> Violation#4-Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br /> This violation was corrected XThis violation will be corrected by (date): May 26, 2022 <br /> Supporting documents included <br /> 3 <br /> Describe actions taken or will be taken to correct violation: Has been submitted via CERS. <br /> I <br /> r <br /> Page 2 of 4 <br /> Rev.9/16l2020 l <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 1 www.sjgov.org/EHD <br />