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ENVIRONMENTAL HEALTH DEPARTMENT <br /> P��. ..� SAN JOAQUIN COUNTY Unit Supervisors <br /> o.-:"• Carl Borgman,R.E.H.S, <br /> Donna R.Reran,x.E-x•s• 304 East`Veber Avenue,Third Floor <br /> { Mike Huggins,R.E.H.S.,R.D.[. <br /> Dri,R E,H.S• Stockton, California 95202-2708 Douglas N.Nilson,R.E.H.S. <br /> Al o <br /> Telephone: (209) 468-3420 Margaret Lago o,R.E.H.S. <br /> o ,`P Program Manager Robert McClellon,R.E.H.S. <br /> 'QCipoP�' Laurie A.Cotulla,R.E.H.S. Fag: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> Program Manager <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address &lo tJEE <br /> J� State OA Zip Code <br /> City <br /> IndustryType <br /> EPAI.D.Number <br /> Phone's <br /> Facility Contact`"" " °F�-F� ssl Title- ' - <br /> S�9 <br /> �� � • Title o�rR- <br /> Consent Given By L <br /> Inspection Type (circle): outine Complaint Follow-Up <br /> Inspection Date(s)---ItIyo�O'� <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization <br /> Rt�'AaiR.— <br /> ��.` <br /> FFba�� IIA SCD �- <br /> ege <br /> e violations <br /> one or more <br /> This reealth and Safety Cod (HSC) oritions <br /> the Califomiabserved this aCode of Rare eig lations Title 22 (22fCCR) r ating t sections <br /> management o <br /> H in .more detail <br /> haza'rdous wast . The evaluation of the informal violobtains y bg thee inspection,tion,you maybe informed f addit onal violations.After completing t <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 p ). <br /> citing you for continuing/additional violations. Issuance of this Inspection Report does not precluc <br /> Health Department(EHD) <br /> Failure to correct these violations within the scheduled period provided may result in San Joaquin County Environment <br /> g Y <br /> EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> 3 �3 <br /> �� Date <br /> E ro tal lth pecialist Received by <br /> Page 1 of5-- <br /> 315/02 <br />