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0 & <br /> ' PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY Y <br /> ENVIRONMENTAL HEALTH DMSION <br /> Karen Furst, M.D., M.P.H., Health Officer <br /> R �p <br /> 304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br /> 2091468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name &I;f <br /> ✓/�''�' S� �� <br /> Address <br /> cityILIA11 State CA Zip Code 7 <br /> EPA I.D.Number � oo <br /> � % 3- � Y <br /> Facility Contact 17 � Phone q/q 5a� 2K, <br /> Consent Given By <br /> Inspection Date(s) 11 b Inspection Type (circle): outine Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Narne 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, PHS-EHD may inform you 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 /> Failur ,to correct these violations within the scheduled period provided may result in San Joaquin County Public Health <br /> Iection <br /> Se s-Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this nsp <br /> R p does n elude RHS-EHD from taking any administrative, civil or criminal action as a result of the violations noted. <br /> i <br /> it me Nefilth Sp ialist Received by Date <br /> 1219198 Page 1 of <br /> A Division of San Joaquin Counry Health Care Services <br />