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SAN JOAQUIN Environmental Health Department <br /> Corrective Action Statement <br /> RE: July 29, 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 for <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Robert Lopez at(209)953-6214 or rlopez@sjgov.org. <br /> Facility name: HABANERO HOTS Submit completed form to: <br /> Facility address: 1024 VICTOR RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: none ATTN: ROBERT LOPEZ <br /> PR0547046 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation #2 -Failed to initially complete and electronically submit a HMBP. <br /> This violation was corrected ❑ This violation will be corrected by (date). . br <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#3-Failed to establish and implement a hazardous materials business plan. a <br /> 3 p <br /> This violation was corrected ❑ This violation will be corrected by (date): r 1 aL <br /> c <br /> Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation #4-Failed to electronically submit the Business Activities or Owner/Operator Identification page. <br /> This violation was corrected ❑ This violation will be corrected by (date): <br /> Supporting documents included J <br /> Describe actions taken or will be taken to correct violation: <br /> Page 2 of 4 <br /> Rev.9/1612020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjgov.org/EHD <br />