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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.siaov.ong/elid <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Oats: <br /> -DS#4111 61" ER3TC )N June 16 20`, <br /> -�zardous material activity in tlr, ._ usinesse-s sect.. . m CE: In addition to any other re!1 <br /> activities and required fields. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BYTHEABOVE NOTED DATES WILL BE BILLEDATTHE CURRENT HOURLY RATE. <br /> T IS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT END'S CURRENT HOURLY RATE <br /> Received By m <br /> Received By(printed nae and title): Date: <br /> (signature): Ge, � — <br /> Inspector I I Inspector(printed name and title(: Inspector Phone: <br /> (signature(: r-'a& -I-� -IRER, r1;bti apeC',ar <br /> Page 2 of 2 <br />