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SAN 1 Q A Q U I N Environmental Health Department <br /> C O -~J <br /> Corrective Action Statement <br /> RE:January 27,2022,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 /> Frederick Ernest at(209)616-3026 or fernest@sjgov.org. <br /> Facility name: GOODWILL INDUSTRIES OF SJV Submit completed form to: <br /> Facility address: 129 S GRANT ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10779607 ATTN:FREDERICK ERNEST <br /> PRO543976 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violatitionn#102-Failed to determine if a waste is a hazardous waste. <br /> 19' This violation was corrected ❑This violation will be corrected by(date): <br /> Ek'--Supporting documents included <br /> Describe actions taken or will be taken to correct violation: �x'PAM <br /> 1l,Dk�(-Y— -* 10 z_ <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 /> Violation#704•Universal Waste Handler failed to properly manage universal waste lamps. <br /> C9"This violation was corrected ❑This violation will be corrected by(date): <br /> GVSupporting documents included <br /> Describe actions taken or will be taken to correct violation: ������ s-e-e- <br /> jle iU tolA-7C1� <br /> Page 2 of 3 <br /> Rev.9/16!2020 <br /> 1868 E.Hazelton Avenue j Stockton,California 95205; T 209 468-3420 j F 209 464-0138 j www.sjgov.org/EHD <br />