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SAN J OAQ U I N Environmental Health Department <br /> Corrective Action Statement <br /> RE: October 07, 2022, 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 form <br /> with the Return to Compliance.Certification within 30 days of inspection. If you have any questions,please contact <br /> Nicholas Loehrer at(209)468-0623 or nioehrer@sjgov.org. <br /> Facility name: MCDONALDS#969 Submit completed form to: <br /> Facility address: 1009 N WILSON WAY SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10180685 ATTN:NICHOLAS LOEHRER <br /> PR0520671 1868 E HAZELTON AVENUE <br /> STOCKTON,CA 95205 <br /> Violation#7-Failed to electronically submit an adequate ER procedures for a release or threatened <br /> release. <br /> AThis 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 /> cw-\ <br /> Page 2 of 2 <br /> Rev.9/1612020 <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 />