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ENVIltONMENTAL HEALTH DEPARTMENT <br />'SAN JOAQUIN COUNTY <br />Unit Supervisors <br />Floor <br />_Donna K. Her , R.E.H.S. Carl Borgman, R.E.H.S. <br />304 East Weber Avenue, Third <br />a� ''''I1II'',� �'< Direc 202-2708 <br />r Mike Huggins, R.E.H.S., R.D.I. <br />1 - `''j•• Al Olsen, .E.H.S. Stockton, California 95Douglas W. Nilson, R.E.H.S. <br />• �.,�P ProgrmManager anager Telephone: (209) 468-3420 Margaret Lagorio, R.E.H.S. <br />9Ci FOR` Laurie A. Cotu la, R.E.H.S.Robert McClellon, R.E.H.S. <br />Program h anager Fax: (209) 464-0138 Mark Barcellos, R.E.H.S. <br />UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br />Facility Name ��1 <br />Address <br />City <br />State CA. Zip Code <br />EPA I.D.Number Industry Type &A D <br />Facility Contact �1 <br />Titte' <br />��►JoV1 � Phone �0•'�g�.5,$�I <br />Consent Given By Title <br />Inspection Date(s) lZ'D Inspection Type (circle): Routin Complaint Follow -Up <br />REPRESENTATIVES PRESENT <br />Name <br />Title Organization <br />Q <br />This report may identify con itions observed ornia Code of Regulahis day that are tions, to be violations f <br />one or more <br />ons, Title 22 (22 a <br />CCR) relating sections <br />to the management of <br />Health and Safety Code (H C) or the Calif <br />described in more detail on the attached note sheets. After completing the <br />hazardous waste. The vio ations may be <br />he inspection, you may be informed of additional violations. <br />evaluation of the information obtained during t <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 <br />p'violations. dlssuance of this Inspectid may result in San on not preclude <br />in County Environmental <br />Health Department (EHD) cling you for continuing/additional <br />EHD from taking any admin trative, civil or criminal action as a result of the violations noted. <br />Environmental Health Specialist <br />eived by Date <br />Page 1 of h <br />3/5/02 <br />