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Environmental Health Department <br />Corrective Action Statement <br />RE: June 07, 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. <br />Also, describe what was done to correct the violation in the space provided below each violation. Submit this <br />completed form with the Return to Compliance Certification within 30 days of inspection. If you have any questions, <br />please contact Vicky Vang-Lee at (209) 616-3028 or vvang-lee@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: VICKY VANG-LEE <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to:QUIK STOP MARKET #152 <br />10180631 <br />1721 S CHEROKEE LN # 1 <br />PR0518706 <br />Violation #110 - Failed to keep signed copy of manifests from the designated facility for three years. <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: <br />Violation #601 - Stored hazardous waste onsite greater than 180 days (90 days acute / extremely). <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: <br />Violation #605 - Failed to completely label containers or portable tanks of hazardous waste. <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: <br />Page 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />X <br />X <br />The missing manifest has been provided to site and is attached. In the future signed manifests will be <br />kept onsite for the required timeframe. <br />Manifest-010666801FLE attached. <br />x <br />x <br />Hazardous waste was disposed of on 6/25/2021. Pictures are attached. In the future hazardous waste will be <br />disposed within the required time time period. <br />x <br />x <br />The yellow plastic container has been labeled and a picture is attached. In the future containers will be <br />labeled as required.