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PUBLIC HEALTH SERVICES <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br />445 N. San Joaquin Street • P.O. Box 388 • Stockton, CA 95201-0388 <br />(209) 468-3420 <br />HAZARDOUS WASTE INSPECTION REPORT <br />Facility Name <br />Address 'K0 LC S. <br />City -S k4f� State CA Zip Code SZ�� <br />EPA I.D.Number c,4 G '57 Z <br />Facility Contact y_CC' 1A le- ra-eIr Phone ZZf - <br />Consent Given Byc <br />Inspection Date(s) z- Z �� Inspection Type (circle): outin 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 <br />California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the <br />management of hazardous waste. The violations may be described in more detail on the attached note sheets. After <br />completing the evaluation of the information obtained during the inspection, PHS-EHD may inform you of additional <br />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 />Failure to correct these violations within the scheduled period provided may result in San Joaquin County Public Health <br />Services -Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this <br />Inspection Report does not preclude PHS-EHD from taking any administrative, civil or criminal action as a result of the <br />violations noted. <br />Registered Environmental Health Specialist <br />12/9/94 <br />G �� nr,cyy <br />Received by <br />A Dkkion or San Joaquin ('nunt-N Health (arc Scnicc, <br />Date <br />Page 1 of <br />