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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.sigov.org/ehd <br /> Hazardous Materials Program inspection Report <br /> Facility Name: Facility Address: Date: <br /> RUBIOS FRESH MEXICAN GRILL 2431 NAGLEE RD, TRACY June 26, 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 paperwol <br /> within 30 days of receiving 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 hftp://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. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By Received By(printed name and title): Date: <br /> (signature): Vilma Portillo, Assistant Manager <br /> Inspect Inspector(printed name and title): Inspector Phone: <br /> (signatur PETER LOMBARDI, HM Specialist 1 (209) 953-6213 <br /> Page 4 of 4 <br />