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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 458-3420 Far: (209) 468-3433 Web:www.si4oy.orci/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> b.. (iN Julie U4, 2014 <br /> Consent to perform the inspection, take photos and collect samples was given by Irma Ulloa; owner. <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 July 4, 2014. <br /> A copy of photos taken at the time of inspection were provided to Irma Ulloa. <br /> Please be aware as of January 1, 2013, all businesses were required to submit all hazardous materials <br /> information online to the California Environmental Reporting System(CERS) at http://cers.calepa.ca.gov. Be sure <br /> to include your hazardous material activity in the Businesses Activities section in CERS in addition to any other <br /> relevant activities and required fields. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE A13OVE NOTED OATES WILL BE BILLED AT THE CURRENT HOURLY RA I t <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By . Title: Date: <br /> X �P o U J LQ ' LL Y <br /> Ins ector: -1T LOPEZ Title: Phone: 209 953-6214 Date: 014 <br /> Page 2 of 2 <br />