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we <br /> San Joaquin County we <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.sioov.orglehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Kmart#4867_ Nolingate Dr, Ma nuary 04, 2016 <br /> sure to incic— hazardow. in the Businesses section in CERS ,n 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 /> HIS FACILITY IS SUBJECT_ ,0,1REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received By Rece6Z <br /> ived By(printed name and thiel: Date: <br /> (signature), , Alma Robles, Store Manager 0 206 <br /> Inspector Inspector(printed name and title): 1 pecto Phone: <br /> (signature): NICHOLAS LOEHRER, HM Specialist 1 (209) 468-0623 <br /> Page 2 of 2 <br />