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ENVIRONMENTAL HEALTH DEPARTMENT <br /> pP�-UIN C SAN JOAQUIN COUNTY Unitsnpervisors <br /> Donna K.Resor R.E.H.S. 304 East Weber Avenue,Third Floor Carl Borgman,R.E.H.S. <br /> Director Mike Huggins,R.E.H.S.,R.D.I. <br /> ' Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas N.Nilson,R.E.H.S. <br /> • • .,: 'p.• Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> 4C]FOR�` Laurie A.Cotulla,RE.H.S. Robert McClellon,R.E.H.S. <br /> Fax: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> Program Manager <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> V I <br /> Facility Name v <br /> Address <br /> �� <br /> Zip Code <br /> city State Z� <br /> EPA LD.Number �- OVU q � IndustryType <br /> Facility Contact <br /> Title Phone <br /> Consent Given By <br /> u Title <br /> Inspection Date(s) Inspection Type (circle): outine Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Narpq <br /> Title <br /> 2 Organization n <br /> AM <br /> r Q <br /> This report may identify conditions observed this day that are alleged to be violations of one or more sections of the CaliforniE <br /> Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management o <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,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 6( <br /> days,unless otherwise specified (A certification form is provided). <br /> in County <br /> Failure to correct these violation within <br /> the scheduled perinal od pronlselssuan result -'nsp ct onSan uReport does not preclud <br /> Health Department(EHD)citing you <br /> EHD from taking any administrative,civil or criminal action as a uit of the viola' oted. <br /> NA (A, <br /> E vironmental Health Spec ist <br /> eceiv d by Date <br /> Page 1 of._�L <br /> 315102 <br />