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ENVIRONMENTAL HEALTH DEPARTMENT <br /> oP SAN JOAQUIN COUNTY <br /> �.. ���.•.off Unit Supervisors <br /> Donna K.Heran,R.E.H.S. Carl Borsman,R.E.H.S. <br /> �. Director 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> Al Olsen,R.E.H.S. StoGlCtrJn, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> ng Telephone: (204) 468-3420 Margaret Lagoaio,R.E.H.S, <br /> Pro rant Manager <br /> ani 6" Laurie A.Cotulia,R.E.H.S. Robert McCleilon,R.E.K.S. <br /> Program Manager Fax: (2Q4) 464-0138 Marl:Barcellos,R.E.H.S.- <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address 92-0 -S . Ct"O <br /> City State OA Zip Code �Z <br /> EPA I.D.Number CAD Industry Type <br /> Facility Contac I#1e: <br /> Phone 2 �' ,� '- <br /> Consent Given By <br /> t� Title � <br /> ins action Date f7 Inspection Type (circle): (Routine) Complaint Follow-Up <br /> p <br /> REPRESENTATIVES PRESENT <br /> erne Title Organization <br /> This report may identify conditions observed this day that are alleged to be violations of one or more sections of the California <br /> Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of <br /> hazardous waste. The violations may be described in more detail on the attached note sheets. After completing the <br /> evaluation of the information obtained during the inspection, you may be informed of additional violations. <br /> if any violations are noted, the facility is required to submit a signed Certification of Return to Compliance within 60 <br /> days, unless otherwise specified (A certification form is provided). <br /> Failure to correct these violations within the scheduled period provided may result in San Joaquin County Environmental <br /> Health Department (EHD) citing you for continuing/additional violations. Issuance of this Inspection Report does not preclude <br /> EHD from taking any administrative, civil or criminal action as a result of the violations noted. <br /> AnvgenntaHealth Specialist Aeived by Date <br /> 315102 Page 1 of <br />