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SAN J OAQ U I N Environmental Health Department <br /> COUNTY <br /> Corrective Action Statement <br /> RE: March 03, 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. <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 Kristina Saetern at(209)616-3045 or ksaetern@sjgov.org. <br /> Facility name: ADRIAN RANCH Submit completed form to: <br /> Facility address: 27107 E RIVER RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10186221 ATTN: KRISTINA SAETERN <br /> PR0529755 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <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 /> '/� <br /> Supporting documents included h, «4�\ <br /> Describe actions taken or will be taken to correct violation: � Y'' Q�'r 1i A AZ KN J <br /> Violation#113 -Failed to keep copies of consolidated manifesting receipts for three years. <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> Supporting documents included G� n <br /> Describe actions taken or will be taken to correct violation: 4AZn <br /> PC 7 <br /> d 1. <br /> Violation#303 -Failed to maintain all communication or alarm systems, spill control, or decontamination <br /> equipment. <br /> 6K 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 /> 1 <br /> C,L :z LA T iii ,� new & <br /> Rev.9!1612020 Page 2 of 3 <br /> 1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />