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05/12/2021 12:16 FAX IA0004/0008 <br /> SAN J O A Q U I N Environmental Health Department <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 nloehrer@sjgov.org. <br /> Manteca Dialysis,1620 W Yosemite Ave, CERS ID: 10733509, PRO543667 <br /> Violation#12-Failed to have the HMBP readily available to facility or EHD personnel. 1 <br /> XThis violation was corrected 13 This violation will be corrected by(date): SI1Z1Z I <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: EMeroe ncV moon ,l pttAn A In-wnTm <br /> was cbrv,nle�tG on S/1#1 A WGA <br /> submM1.6 �'o LM h4— Dav>irA L Cclnu a C rhFICCA%A ©Y) Sliilz) . <br /> the ��1u`t1 w►II b� C�mn�-�KGI Imo/ A a u1711 b� rtl,bm%1'1- of �o <br /> JGn IS4h OF C'Ckch MlllnCtak- \U0�✓ 0s Pati' (}V <br /> f h� n1G n dG co rKte "D \• FA "J" <br /> 1 00-0 Pn A+ G Coloy 0'c <br /> PICACQ 1f Qp +h� �ilSotj�~tr o1nr�2� fi0 be <br /> �-�Gcitiy ne avG�tU+�Lc, �Y revlzut. <br /> Page 4 of 4 <br /> Rev.9/16/2020 <br /> 1868 E.Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.orglEHD <br />