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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY , <br /> ENVIRONMENTAL HEALTH DMSION <br /> Karen Furst, M.D., M.P.H., Health Officer � <br /> 304 East Weber Avenue, Third Floor • Stockton, CA 95202 %FaR� <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address I yo- <br /> City <br /> o 77City ( �"— State CA Zip Code �� <br /> EPA I.D.Number l /'r () 0 �� l S �J 117 <br /> Facility Contact �� � ' ` ��, �' 1' Phone -2 <br /> Consent Given By <br /> Inspection Date(s) �� Inspection Type (circle): outi Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> j� Title /� Organiza ' n <br /> oe <br /> This report may identify conditions observed this day that are alleged to be violations of one or more sections of the California <br /> Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of <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, PHS-EHD may inform you 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 in San Joaquin County Public Health <br /> Service Environmental Health Division (PHS-EHD) citing you for continuing/additi al violations. Issuance of this Inspection <br /> Report does not preclude PHS-EHD from taking any a iritstf tive,civil or cri 'nal tion as a result of the viola ions noted. <br /> i v ronmental Health Specialist R eive by Date <br /> 12/9/98 Page 1 of <br /> A Division of San Joaquin County Health Care Services <br />