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FROM, :-SRC_INVESTMENT PHONE NO. : 19164897107 0SSep. 12 2000 10:14RM P2 <br /> �H <br /> SERVICES QP4lu i!y o <br /> PUBLIC H /c aY z <br /> a <br /> $AN JOAQUIN COUNTY a; <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Karen Furst, M.D., M.p.1-1., Heath Officer <br /> 304 East Weber Avenue,Third Floor <br /> * Stockton, CA 95202 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address <br /> State CA Zip Code _ �0 <br /> city <br /> EPA I.D.Number <br /> r qJ Phone <br /> Facility Contact �� t <br /> Consent Given By t`t <br /> �r - CU inspection Type (circle): outi Complaint Follow-Up <br /> Inspection Date(s) <br /> REPRESENTATIVES PRESENT <br /> e <br /> Title rganization <br /> l ut <br /> one or more <br /> ons of the <br /> ia <br /> This report may identify Codeo(HSC) or the California served this ay that are Code of Reg ulado�be Title 22 (22 ations fCCR) relating t tithe management of <br /> Health and Safety <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 /> uin <br /> ty <br /> lic <br /> th <br /> Failure to correct these violations within the scheduled period fopcontintling/addmay tionalsult ln San violatonsaglssuancenof th sbInspectiion <br /> Services-Environmental Health Division (PHS-EHD) citing y <br /> Report does not <br /> preclude PWS-EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> Environmental Heal h�Speclallst� <br /> Received by e <br /> Page 1 of <br /> 1219/98 <br /> A Division or San Joaquin County Health Care Services <br />