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Aug. 18, 2015 4,05PM HAP V BEE"S No. 2041 P, 29 <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Pax:(209)468.3433 Web:www.sjgov.org/ehd <br /> r <br /> Facility Name: Facility Address: Date: <br /> PERKOS CAFE 1321 W ELEVENTH ST,TRACY July 27,2015 <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting paperwo <br /> within 30 days of receipt of this inspection report. <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials information <br /> online to the California Environmental Reporting System(CERS) at http;#cers.calepa.ca.gov. Be sure to include yo <br /> hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant activities <br /> and required fields. RECEIVED <br /> AUG 182015 <br /> EWRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> ALL EHD STAFFTIME ASSOCIATED WITH FAILING TO 00MI)MYTHE ABOVE NOTED DATES WILL BE BB.LEDAT THE CURRE14T HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By Received ay tprinted name and title): Date: <br /> (signature), Kim Montoya, Manager <br /> Inspector Inspector(printed name and tide): Inspector Phone: <br /> (signature): PETER LOMBARDI, HM Specialist 1 (209)953-6213 <br /> Page 4 of 4 <br />