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ENVIRONMENTAL HEALTH DEPARTMENT <br /> PpUIN SAN JOAQUIN COUNTY unitsupervisors <br /> Carl Borgonan,R.E.H.S. <br /> 304 Est Weber Avenue,Third Floor <br /> Donna K.Heron, aMike Huggins,R.E.H.S.,R.D.I. <br /> Director <br /> Al Olsen,R.E.H.S. Stockton, California 95202-2709 Douglas W.Wilson,R.E.H.S. <br /> Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> Program Manager Robert McClellon,R.E.H.S. <br /> it Laurie A.Cotulla,R-E-H-S- Fax: (209) 464-0138 <br /> FO program Manager Mark Barcellos,R.E.H.S. <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address <br /> State.CA Zip Code <br /> City <br /> EPA I.D.Nurnber industry <br /> Type <br /> Title:2!6 k T.:�A—Phone j��� <br /> Facility Contact SV*4 na;�� <br /> Consent Given By Title <br /> Inspection Date(s) Inspection Type (circle): ou i Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Title Organization <br /> Name <br /> W-1 <br /> This report may identify conditions observed this day that are alleged oto be violations of one or more sections of the agement ceiiforn!E <br /> ns, Title 22 (22 CC�R) relating to the magement 0 <br /> Health and Safety Code (HSC) or the calffomia Code of RegulatiI 'on the attached notel sheets. After completing thE <br /> hazardous waste. The violations may be described in.more detatiViolations. <br /> evaluation of the information obtained during the inspection,you maybe l nformed of addionai <br /> If any violations are noted,the facility is required to submit a signed Certification of Return to compliance within 6 <br /> days,unless otherwise specified(A certification form is provided). <br /> Failure to correct these vlations within the scheduled period provided sumay result in San County Environment <br /> ulngladditional violations. isance of this inspectionJoaquin Report does not precluc <br /> Health Department(EHD)iociting you for contin I t. ns noted <br /> EHD from taking any administrative,civil or criminal action as a repult of the violaf , - <br /> N 4 0 <br /> 2, <br /> �ronment Hea cialist <br /> Received Date <br /> Page 1 of <br />