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PUBLIC HEALTH SERV'TCES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION :< <br /> Karen Furst, M.D., M.P.H., Health Officer .. P.. <br /> 304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name S � <br /> Address <br /> City - State CA Zip Code <br /> EPA I.D.Number ('.00 q18--7 l 12 <br /> Facility Contact "' rrj- Phone '' — i <br /> Consent Given By G <br /> Inspection Dates) 6 Inspection Type (circle). Routi e Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name 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 /> L) <br /> If any violations are noted, the facility is required to submit a signed Certification of Return to Compliance withir>x <br /> days, unless otherwise specified (A certification form is provided). <br /> Failure to correct these violations within the scheduled period provided may result in San Joaquin County Public Health <br /> LSReport <br /> rvices-Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this Inspection <br /> does not preclude PHS-EHD from taking any administrative, vil or riminal action as a result of the violations noted. <br /> Qa <br /> vironments Health Specialist Receive y bate <br /> 9198 Page 1 of7 <br /> A Division of San Joaquin County Hcalrh Care Services <br />