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S A N J O AQ U I N Environmental Health Department <br /> COUNTY_ , <br /> Corrective Action Statement <br /> RE: April 29, 2021, Hazardous Waste 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 /> PR0539211 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#110-Failed to keep signed copy of manifests from the designated facility for three years. <br /> XThis violation was corrected ❑This violation will be corrected by(date): J3 p)JZp21 <br /> a Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> C-!' e <br /> Violation#111 -Failed to comply with uniform hazardous waste manifest exception requirements. <br /> w. This violation was corrected ❑This violation will be corrected by(date): p <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> C ' ' r!4- SAcwMc+w^ fig_ CA rCC *nn Saks,'L+,4 -- iCle eh s <br /> ��r I w4l% 1 rcoryi MC4W"-tSt <br /> Violation#113-Failed to keep copies of consolidated manifesting receipts for three years. <br /> X, This violation was corrected ❑This violation will be corrected by(date): Q 4> Ce <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Gr'- Sficr k-firm has Ck gA t!, +a - ltle-en S <br /> Page 2 of 3 <br /> Rev,911612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www sigov org1EHD <br />