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ENVIRONMENTAL HEALTH DEPARTMENT <br /> ou SAN JOAQUIN COU Unit Supervisors <br /> o?. oqCarl Boreman,R.E.H.S. <br /> �. <br /> rr �� ?a Donna K.xeran,R.E.Hs. 304 East Weber Avenue,Third OOr Mike Huggins,R.E.H.S.,R.D.I. <br /> Director Douglas R'.Wilson,R.E.H.S. <br /> Stockton, California 95202-2708 <br /> R <br /> At Olsen,R.E.H.S. Margaret Lagorio,R.E.H.S. <br /> .P• Program Manager Telephone: (209) 468-3420 Robert McClellon,R.E.H.S. <br /> • OqQ9'6'1 ` Laurie A.COWIN,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 /> Facility Name <br /> Address <br /> State CA Zip Code <br /> City <br /> IndustryType <br /> EPA I.D.NumberQJ Q- <br /> Facility Contact " <br /> Phone <br /> Title���- <br /> Consent Given By <br /> inspection Datt,(s) <br /> �\;\ Inspection Type (circle): outine Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Title Organization <br /> Name <br /> Regulations, Title 22 (22 CCR) relating to the management , <br /> This report may identify con <br /> se Cali this day that Code of alleged to be violations of one or more sections of the eanfomr <br /> Health and Safety Code (HSC) be described in more detail on the attached note sheets. After completing <br /> hazardous waste. The violations may be informed of additional violations. <br /> evaluation of the information obtained during the inspection,you may <br /> , the facility is required to submit a signed Certification of Return to Compliance within <br /> If any violations are notedf <br /> days, unless otherwise specified(A certification form is provided)* result in San Joaquin County Environmen <br /> Failure to correct these violations within the scheduled period provided may <br /> s issuance of Report does not preclu <br /> Health Department(Eadministrative,) ting <br /> civil or inui nal action as a natio of the violations tnloted.pectioh Rep <br /> EHD from taking any <br /> 0 <br /> N.Ar"G `� Date <br /> Received by <br /> En ' onm Hea pecialist <br /> page 1 of. 5 <br /> 3/5/02 <br />