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N JOAQUIN Environmental Health Department <br /> Corrective Action Statement <br /> RE : April 25 , 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 <br /> form with the Return to Compliance Certification within 30 days of inspection . If you have any questions , please <br /> contact Frederick Ernest at (209) 616-3026 or fernest@sjgov . org . <br /> Facility name : DAMERON HOSPITAL SURGICAL PAVILION Submit completed form to : <br /> Facility address : 445 W ACACIA ST SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10182991 ATTN : FREDERICK ERNEST <br /> PR0514081 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #105 - No emergency coordinator available for emergency response . <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 #712 - Universal Waste Handier failed to label universal waste . <br /> This violation was corrected ❑ This violation will be corrected by ( date) : <br /> I� upporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> of <br /> Page 2 of 2 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 T 209 468- 3420 F 209 464- 0138 1 www . sjgov . org/EHD <br />