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Greofriess grows here. <br />SAN.JOAQUIN tit _ COUNT y_ <br />diratvar, <br />Environmental Health Department <br />Corrective Action Statement <br />RE: February 09, 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. 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 />Garrett Backus at (209) 468-2986 or gbackus@sjgov.org. <br />Facility name: <br />Facility address: <br />CERS ID: <br />MANTECA DENTAL CARE <br />1007 S MAIN ST <br />10864561 <br />PRO546502 <br />Submit completed form to: <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: GARRETT BACKUS <br />1868 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 <br />Supporting documents included <br />0 This violation will be corrected by (date): <br /> <br />Describe actions taken or will be taken to correct violation: <br />Violation #715 - Universal Waste Handler failed to keep three years records of each shipment of universal <br />waste. <br />El This violation was corrected <br />Supporting documents included <br />0 This violation will be corrected by (date): <br /> <br />Describe actions taken or will be taken to correct violation: <br />Violation #3010 - Unlisted Administration/Documentation violation. <br />This violation was corrected <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 />0 This violation will be corrected by (date): <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjgov.org/EHD