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0 <br />SAN MUM <br />•Environmental Health Department <br />Hazardous Materials Program Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />JACQUELINE POLK <br />10549 N JACK TONE RD, STOCKTON <br />March 23, 2018 <br />Item i! I Remarks <br />Overall Inspection Comments: <br />Final Inspection conducted. Business related hazardous materials are no longer being stored at this facility. <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 />RECEIVED <br />JUL 0 2 2W <br />ENVIRONMENTAL HEALTH <br />PERMITISERV!CES <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: March 26, 2018 <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />CESAR RUVALCABA, EH Specialist <br />(209) 953-6213 <br />Mailed, <br />FAD017247 PRO525432 SCO01 03/23/2018 <br />EHD 19-01 Rev. 10/31/2017 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 />