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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 868 East Hazelton Avenue, Stockton, Califomia 95205-6232 <br /> Te/ep one:(209)468-3420 Fax:(209)468-3433 Web:www.s6gov.o[g/ehd <br /> CONTINUATION FORM Page: 5 of 5 <br /> OFFICIAL INSPECTION REPORT Date: 07/11/12 <br /> Facility Address: 440 W. Dr. Martin Luther King, Jr. Blvd., Stockton Program: HW <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Complete and submit a co y of the Return to Compliance Certification form to the EHD by August 11, <br /> 2012, along with a statement documenting the corrective actions that have been or will be taken for each <br /> violation, and any supporting paperwork. <br /> Note: According to Mr. Singh, this facility has not generated any hazardous waste. He stated that the <br /> used absorbent is placed b ck into the container for reuse. <br /> Provided: <br /> - California Hazardous Waste Permanent ID Number Application <br /> - Small Business Househol J Hazardous Waste brochure <br /> - Sample hazardous waste label <br /> - Hazardous waste labels <br /> - Universal waste label <br /> - Return to Compliance Ceitification form <br /> ALL EHD STAFF TIME ASSOCIA D WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SU ECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: Title: <br /> Stacy Rivera (209) 468- 440 <br /> EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />