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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY ur6 ENVIRONMENTAL HEALTH DMSION Karen Furst, M . D . , M . P. H . , Health Officervt <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 <br /> City r-reStatf� / <br /> State CA Zip Code � /, <br /> EPA I . D . Number � 7J �S <br /> Facility Contact � ; Phone Z <br /> Consent Given By <br /> Inspection Date (s ) VZT1 <br /> �v Anspection Type ( circle ) :4.. <br /> Complaint Follow- Up <br /> REPRESENTATIVES PRESENT <br /> me <br /> Title <br /> Orga atn 2 <br /> pG <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 t ' 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/additional violations . Issuance of this Inspection <br /> Rep oes not precl de PHS- EHD from taking any administrative , civil or criminal action as a result of the violations noted . <br /> C q /3F0C) <br /> nvi onmental Wealth Specialist Rec ived by jor Date <br /> 12/9/98 Page 1 of _ <br /> A Division of San Joaquin County Health Care Services <br />