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HEALTH SERVICESPUBLIC <br /> SAN JOAQUIN COUNTY = <br /> ENVIRONMENTAL HEALTH DMSION ;.��► <br /> Karen Furst, M.D., M.P.H., Health Officer <br /> �jFORN <br /> 304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address �� ®�� Ai n <br /> Ciry _� �(�K-�-n State CA Zip Code <br /> EPA I.D.Number <br /> Facility Contact EA <br /> Consent Given By <br /> Inspection Date(s) Inspection Type (circle): Routine Complaint Follo`v-Up <br /> REPRESENTATIVES PRESENT <br /> Title Or anization <br /> Name.. �...,,I � � P��S- <br /> �t VI <br /> This report may identify conditions observed this day that are alleged to be <br /> viol ti n22 f one or relating more sections <br /> of the cavorno' <br /> Health and Safety Code (HSC) or the California Code of Regulations, <br /> Titlehazardous waste. The violations may be described in more detail on the PHS EHD may inform you additional violations(d note sheets. Aftecompleting the <br /> evaluation of the information obtained during the inspection, <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 /> ��tion <br /> Failure to correct these violations within the scheduled <br /> PeooffoPcontinui gladdtionmay lallviolatons Issuann San Joaquin cenoftty hisbinsp lic calf' <br /> Services-Environmental Health Division (PHS EHD) citing y <br /> Report does not preclude PHS-EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> D s is <br /> lEnviro�nMmentalHeaSpeci is <br /> Received by Date <br /> Page 1 of <br /> 12/9198 <br /> A Division of San Joaquin County Health Care Services <br />