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d ENVIRONMENTAL HEALTH DEPARTMENT <br /> PQU,IN SAN JOAQUIN COUNTY Unit Supervisors <br /> Carl Bergman,R.E.H.S. <br /> r.` a' •9 ? Donna K.Heran,R.E.H.S. 304 East Weber Avenue, Third FlOOI Mike Huggins,R.E.H.S.,R.D.I. <br /> Director Douglas W.Wilson,R.E.H.S. <br /> Al Olsen,R.E.H.S. Stockton, California 95202-270 Margaret Lagorio,R.E.H.S. <br /> p• Program Manager Telephone: (209) 468-3420 Robert McClellan,R.E.H.S. <br /> a4T 'Fda`'� Laurie A.Cotulla,R.E.H.S. Fax: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> Program Manager <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> d <br /> Facility Name <br /> Address <br /> �� State .CA Zip Code <br /> City 6 b 1�n / B,+R W---) <br /> nAOA <br /> Industry Type a t <br /> EPA I.D.Number <br /> Facility Contact <br /> Phone 7!�a' v <br /> Consent Given By _Title <br /> Inspection Date(s) <br /> (� Inspection Type (circle): utin Complaint FOIIOW-Up <br /> REPRESENTATIVES PRESENT <br /> Organization <br /> Title <br /> me I R v <br /> one or more <br /> ons of the California <br /> This report may identify conditionsCor the Californiaa <br /> aCode of Regulaare alleetions, Title 22 (22to be violations tCCR) relating t ti <br /> Health and Safety Code (HSC) or <br /> management of <br /> hazadous waste. he ribed in more detail on <br /> e attached note sheets. <br /> evaluration of he informat otnlobta obtained during thee inspection,you may be inforlmed of additional violations.After completing the <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). Environmental <br /> Failure to correct these violations within the scheduled period provided may result San Joaquin County <br /> Health Department(EHD) citing you for continuing/additional violations. Issuance of this Inspection Report does not preclude <br /> EHD from <br /> D t*eD totaking any administrative, civil or criminal action as a result of the violations noted. <br /> Received by <br /> nvironmental Health Specialis <br /> Page 1 of <br /> 3/5/02 <br />