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OFFICE NO, �S FAJLITIES INSPECTION REjfRT <br /> PG\Systttn Truk So: /1� <br /> INSPECTOR: TIMOTHY R. O'BRIEN <br /> S13397035001 CALIF CONCENTRATE COMPANY CALIFORNIA CONCENTRATES <br /> t4D5 Nl \IBER NAME OF:\GENCY OR PARTY RESPONSIBLE FOR DISCHARGE <br /> NA\IE OF FACILITY <br /> IS67S \ HICHtb'aY 99 _ 18678 HWY 99 <br /> NPDES Nt \1B6R <br /> AGENCY STREET FACILITY STREET <br /> nnnI n t \(']\IPfI C' s <br /> FACILITY CITY AND STATE <br /> IYYI i\I>1�,TFPE) AGENCY CITY ASD STATE <br /> SCHED INSPECT DATE <br /> ANDY ALEXANDER DENINIS ALEKkNDER <br /> AGENCY CONTACT PERSON FACILITY CONTACT PERSON <br /> Z 71x' 33y 9// z— <br /> ACTUAL INSPECTION DATE AGENCY PHONE NO. <br /> FACILITY PHONE NO. <br /> INCPFC'TICIN TVPF Whrrk OnPI <br /> (Al) "A"type compliance--Comprehensive inspection in which samples are taken. (EPA Type S) <br /> B "B"type compliance--A routine nonsampling inspection.(EPA Type C) <br /> (02) Noncompliance follow-up--Inspection made to verify correction of a previously identified violation. <br /> (03) Enforcement follow-up--Inspection made to verifv that conditions of an enforcement action are being met. <br /> (04) Complaint--Inspection made in response to a complaint. <br /> (05) Pre-requirement-- Inspection made to gather info,relative to preparing,modifying,or rescinding requirements. <br /> (06) Miscellaneous--Any inspection type not mentioned above. <br /> If this is an EPA inspection not mentioned above,please note type. <br /> (e.g.-biomonitoring,performance audit,diagnostic,etc.) <br /> (Type) <br /> Were VIOLATIONS noted during this inspection? (Yes/No/Pending Sample Results) <br /> AZ Was this a Qualitv Assurance-Based Inspection?(YiN) <br /> AJ Were bioassav samples taken?(N=No. If YES, then S=Static or F=Flowthrouah) <br /> --------------------- <br /> INSPECTION SUMMARY (REQUIRED) (100 character limit) <br /> iTG caO.s f/��� / +�b..JG�I/�/i/.�lJ/I TPi��� //"t fU�'�f.� ✓ � <br /> r7//'ity <br /> INSPECTOR'S DATA: O3/O//Da <br /> DATE T <br /> INITIALS SIGNATURE <br /> For Interna: L'se:Resie,.ed By:11) `�� ('-) t-I <br /> Reg.SWIM Coordinator <br /> SWIM Data Entry Date: Regional Board File Number: <br />