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SAN J OAQ O I N Environmental Health Department <br /> i 3 .ln <br /> lltin �a COUNTY <br /> Greotnr`ss grows here <br /> Corrective Action Statement <br /> RE: April 29, 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 form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Haza Saeed at(209)953-6212 or hsaeed@sjgov.org. <br /> Facility name: Delta Water Supply Project Submit completed form to: <br /> Facility address: 11373 N LOWER SACRAMENTO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10423735 ATTN: HAZA SAEED <br /> PR0539212 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#4-Failed to electronically submit the Business Activities or OwnerlOperator Identification page. <br /> 0, 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 /> cr���1 At Q 5 cr.N.� �v. c� ,.��x✓ rcti c'-r - EPA 11 b r <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> jff` 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: Cu '4— -P\ \_WLQ � <br /> CC;.�_,c..e.v1_Arc Jto \_.S. <br /> Violation#6-Failed to electronically submit a site map with all required content. <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: G <br /> L 3 l t er eInc If <br /> Page 2 of 4 <br /> Rev 9/1612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-342C i F 209 464-0138 1 www.sjgov.org/EHD <br />