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05/12/2021 12:16 FAX Z 0002/0008 <br /> S h N `O h Q U I N Environ Cental Health Department <br /> N r- :--.1 . N, ,. <br /> Corrective Action Statement <br /> RE: May 07, 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 /> Nicholas Loehrer at(209)468-0623 or nloelirer@sjgov.org. <br /> Manteca Dialysis, 1620 W Yosemite Ave, CERS ID: 10733509, PRO543667 <br /> Violation#7-Failed to electronically submit an adequate ER procedures for a release or threatened <br /> release. t <br /> This violation was corrected ❑This violation will be corrected by(date): S1 12!2,1 <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: WCt'NKU ' FOK G �tU(A)Q 0C <br /> Thrt( n-cb Edfau, "m wry-) submlWd -o Cen PGofiai, Wamuyt/ <br /> a U VI%-Outon On 5-111W . 80-nua l cQ b rnms on DG I.U.2 EX AL(b (1111) <br /> N clonR bq_ bAn tSthpv7 Crch+c a,41erWa r Day ns po(t dP <br /> i Q P1Un `JG coy rlO on. <br /> Violation#8-Failed to establish and electronically submit a reasonable or an adequate training program. <br /> AThis violation was corrected ❑This violation will be corrected by(date): 51 t217 I <br /> ❑ Supporting documents included 1 <br /> Describe actions taken or will be taken to correct violation: trnnlNe6 rfAlnln o R1rAn Uj(,0 <br /> c � b4 UMCA Li UMOL r,e(tl R (A M 00 s)a 'I <br /> Anriiiial SllffliSStw 01: tum. fVM S ujr1 r)L )Gn 1% a <br /> Violation#9-Failed to annually review and certify that the HMBP is complete and accurate by the due date. <br /> This violation was corrected ❑This violation will be corrected by(date): SIIZIL I <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Q(Au " LlUhsy a c (b1)(CA in 51121E1 Arnuc l rtbmt.t�toq <br /> ov -mQ)4 porn) M11 M dUy)� bg )CAO ISJr nF CaGr) C(tif1tnaj2V- <br /> (.LAK oLJ n(A4 r)l IN pjcAn 0G CUTrlLA(pn . <br /> Page 3 of 4 <br /> Rev 9116/2020 <br /> 1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />