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Environmental Health Department <br />Facility Name: Facility Address: Date: <br />Sears #2059/6805 3350 Naglee Rd, Tracy January 19, 2016 <br />Overall Inspection Comments: <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 <br />paperwork, by 2/18/2016. <br />Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials <br />information online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be <br />sure to include your hazardous material activity in the Businesses Activities section in CERS in addition to any <br />other relevant activities and required fields. <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />THIS FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received by: Date: <br />Inspector: <br />Inspector Phone: <br />Printed Name and Tide: <br />NICHOLAS LOEHRER, Haz Mat Specialist 1 <br />(209) 468-0623 <br />FAC014393 PR0519251 SC001 01119/2016 <br />EHD 19-01 Rev. 1013112017 Page 2 of 2 Hazardous Materials Program OIR <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />