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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> UrfitSrspervisors <br /> Donna K.Heran,R.E.H.S. Carl Borgman,R.E.H.S, <br /> Director 304 East Weber Avenue, Third Floor Mike Huggins,R.F.H.S..R.D.s. <br /> '.•�` Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas W.Nilson.R.E.H.S. <br /> Program,Manager' Telephone: (209) 468-3420 `IarQaret Lagorio,R.E.H.S. <br /> i.F o610" Laurie A.Cotulla,R.E.H.S. Robert McCletlon,R.E.H.S. <br /> Program �, anagen Fax: (209} 46 -0138 Mark Barcellos,R.E.H.S. <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name ? <br /> Address <br /> State fA Zip Code C'J2f�LC <br /> City _ <br /> EPA I.D.Number (i �` 1`�� _Industry Type <br /> Facility Contact ,5i;t�c�,�'� Title' <br /> (` honeM,CIS?)- Ig N1 <br /> It <br /> Consent Given By Title <br /> Inspection Dates) ° Inspection Type {circle): (Routin Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title., r <br /> Organization <br /> l� <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 Califoescribed�nomoee detail anTitle <br /> the attached note relating <br /> s.t© the management of <br /> After completing the <br /> hazardous waste, The violations may be d <br /> evaluation of the information obtained during the inspection, you may be informed 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 /> in County Environmental <br /> Failure to correct these violations within the scheduled itional period <br /> iolation aedmay result in San lssuance of this Inspection uRep rt does not preclude <br /> Health Department(EHD)citing you for continu g <br /> EHD from taking any administrative, civil or criminal action as a res t of the violations noted. <br /> Received by Date <br /> Environmental Health Specialist <br /> Page 1 of <br /> 315102 <br />