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N40IIIN Environmental Health Department <br /> I�1 1J <br /> COUNTY <br /> Greotness grows here. <br /> r. <br /> Corrective Action Statement <br /> RE: May 10, 2024, 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. <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 Maria Lopez at(209)616-3064 or MELOPEZ@SJGOV.ORG. <br /> Facility name: STKN MUD WATER WELL#20 Submit completed form to: <br /> Facility address: 8551 West Ln SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10183741 ATTN: MARIA LOPEZ <br /> PR0512959 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <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: HMBP inventory was updated and submitted on 1/22/2025. <br /> The used oil drum was removed from the site. Lubrication oil is included in the HMBP inventory. Chlorine is no lonaer used or <br /> stored onsite. <br /> Violation#6-Failed to electronically submit a site map with all required content. <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: An updated site map was submitted on 1/22/2025 and includes <br /> a loading zone.The label for chlorine was removed from the site map and there is no plumbed eyewash shower station at the site. <br /> Violation#7-Failed to electronically submit an adequate ER procedures for a release or threatened release. <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: An updated Emergency Response/Contingency Plan was <br /> submitted 3/12/2025. <br /> Page 2 of 3 <br /> Rev.9/16/2020 <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 />