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,, SEI V EL <br /> San Joaquin County JUN 3 0 2015 <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California95205-6232 �1 �i h' Igo <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:wWw.sioov.oryeha IV�RONMENTAL <br /> -I 1r01oT+er_ni— <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Dam: <br /> SUBWAYt5967 078 N WILSON Way, STOCKTON June 18, 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 <br /> paperwork, by 7/18/2015 , <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 <br /> your hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WBE ILL BA <br /> ILLEDT 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): 111, ; ; r7 7j 'T :, I ,.1, <br /> Inspector Inspector(printed name and title) Inspector Phone: <br /> c <br /> (signature): ) ' Pl;Cr .-- - <br /> Page 4 of 4 <br />