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SAN J O A Q U I N Environmental Health Department <br /> L-UUN l Y <br /> ureolnCss ;rows het <br /> Corrective Action Statement <br /> RE: August 23, 2021, Hazardous Waste inspection report <br /> 1 For each violation listed below,indicate if the violation has been corrected or will be corrected by a certain date. <br /> Also,descnbe 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 Lydia Baker at(209)616-3046 or(baker@sjgov.org. <br /> Facility name: AMERICAN EAGLE OUTFITTERS 68 Submit completed form to: <br /> Facility address: 4950 PACIFIC AVE STE 225 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 113769635 ATTN:LYDIA BAKER <br /> PRO544268 1866 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#102-Failed to determine If a waste is a hazardous waste. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> ASupporting documents included <br /> Describe actions taken or will be taken to correct vmlation: <br /> Will 4RVSeA mdv2 ✓i e <br /> WG(sS 6 <br /> ='r <br /> Violation#104-No modified contingency plan. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> supporting documents Included <br /> Describe actions taken or wilt be taken to correct violation: <br /> ItiSic mti n�enc J n d Ub bu �1> rv2. <br /> f t.�.t,d 'L'i ru <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 /> Page 2 of 3 <br /> Rev.9l19/2020 <br /> 1868 E.Hazelton Avenue I Stockkan,Gaiifomia 95205 1 T 209 468-3420 1 F 209 464-0138 1 wwwsjgov.orglEHD <br />