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Y <br /> PUBLIC HEALTH SERVICES <br /> r.: <br /> SAN JOAQUIN COUNTY � /i��r -a' <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Karen Furst, M.D., M.P.H., Health Officer clFaR� <br /> 304 East Weber Avenue,Third Floor • Stockton, CA 95202 <br /> 2091468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address <br /> 4 <br /> City ���� �-GU"VY�� <br /> State CA Zip Code <br /> EPA 1.D.Number C�C�I. 'JSJ <br /> Facility Contact 6d C <br /> Phone <br /> Consent Given By 2L <br /> Inspection Dates)A4U outine— <br /> Inspection Type (circle): RComplaint Follow-UP <br /> REPRESENTATIVES PRESENT <br /> Title Organization <br /> Name � <br /> � -tm <br /> 11 11 <br /> ia <br /> ort may identify conditions observed this day that are alleged to be itlevio! 22n22f one or more CCR) relating totlons of the the managemeontnof <br /> This rep Y <br /> Health and Safety Code (NSC) or the California Code of Regulations, <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, PHS-EHD may inform you of additiona4 violations. in 50 <br /> If any violations are noted, the facility is required to submit a signed Certification of Return to Compliance with <br /> days, unless otherwise specified (A certification form is provided). <br /> uin County Failure to correct these violations within the scheduled peon opro iidedi gladd to may It iviolan J aglssuance of thisbnspection <br /> Services-Environmental Health Division (PHS-1g an admiciting y <br /> Report does not preclude PHS-EHD from taking any administrative,civil or criminal action as a result of the vio4ations noted. <br /> Environmental Heat Special' t <br /> Received by Date <br /> Page 1 of <br /> 12!9198 <br /> A Division of San Joaquin Councy Health Care Services <br />