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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUN G1tit Supervisors <br /> ooCarl Bergman,R.E.H.S. <br /> "?, Donna K.Heran,R.E.H.S. 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> < Director Douglas V. Wilson,R.E.H.S. <br /> Al Olsen, or B.S. Stockton, California 93202 2708 <br /> Telephone: (209) 468-3420 Margaret Lagoao,R.E.H.S. <br /> Program Afan"e'' Robert McClellon,R.E.H.S. <br /> g iFoa Laurie A.Cotulla,R.E.H.S. Fax: (209) 464-0138 <br /> Mark Barcellos,R.E.H.S. <br /> A'ogrnm Afanager <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name A <br /> Address 0 ,D <br /> _� A _State �,L Zip Code <br /> City <br /> Z Indust Type Own <br /> EPA I.D.Number C 1 `9`96 2 �—L___4_ Phone CS^ -�� <br /> Facility Contact Agm <br /> ` � Title � °' <br /> Title <br /> I �, L p (eA <br /> Consent Given By ( � <br /> Inspection Date(s) Routi <br /> Inspection Type (circle): n Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Organization <br /> Name <br /> Title n I t <br /> This report may identify conditions observed this day that are alleged to be violations of one or more sectithe ons of the Californof <br /> ia <br /> CodhHealth and azardous waste Code The violations r the may California bed en mof ore detail on the attached note egulations, Title 22 (22 CCR) r slheetts ng to After completing management <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 /> Failure to correct these violations within the scheduled period provided may result San Joaquin County Environmental <br /> HHD h Depart g lations <br /> Healtament (EHD))initing you <br /> for <br /> ilcorncrim nal acdtitonnas aal '�esuit of the v olationsissuance of tn'oted.pection Report does not preclude <br /> om <br /> civ <br /> D <br /> eceived by <br /> e <br /> Enironmental Health Speciali <br /> - Page 1 of <br /> 3/5102 <br />