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Environmental Health Department <br />Corrective Action Statement <br />RE: August 06, 2024, 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 />Paul Nso at (209) 616-3049 or pnso@sjgov.org. <br />SJC ENVIRONMENTAL HEALTH DEPARTMENT <br />ATTN: PAUL NSO <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Facility name: <br />Facility address: <br />CERS ID: <br />Submit completed form to: <br />10920256 <br />Tesla, Inc. <br />PR2400242 <br />Violation #12 - 3030053 - Kept records of any test results, waste analyses, or other determinations. <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 #13 - 3030006 - Determined land disposal restrictions for 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 #49 - 3030039 - Emergency coordinator on the premises or on call. <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 />Page 2 of 2 <br />Rev. 9/16/2020 <br />1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjgov.org/EHD <br />'Flammable Debris' waste stream managed as D001 and state code 352. The results of the analysis <br />concluded this waste stream is Non-RCRA Hazardous Waste with only Zinc over the thresholds for TTLC. <br />All other analysis resulted in non-hazardous for both Federal and State limits. <br />New emergency coordinator has been <br />updated on CERS as of 8/10/2024. <br />A new analysis was conducted on 9/10/2024 for the <br />A copy of the LDR notification form for profile managed <br />as D001/352 during 8/6/2024 inspection is attached to this report. <br />E S