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i 1 <br /> HEALTH SERVICESPUBLI G <br /> SAN JOAQUIN COUNTY r. z <br /> E RONMENTAL HEALTH DMSION n <br /> ren Furst, M.D., M.P.H., Health Officer CC <br /> ��FOR <br /> 304 East'Reber Avenue,Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED ROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name � LA- <br /> Address <br /> city `mac C- State CA Zip Code <br /> EPA I.D.Number C i • w -2 4 12-C <br /> - <br /> Facility Contact C C� rel I l i 4C 4LjL.Phone a0 l ' 4 -- q Q'14�_ <br /> Consent Given By <br /> Inspection Date(s) -Inspection Type (circle): Boutin , Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title fl� Organization <br /> This report may identify conditio s 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 violati ns may be described in more detail on the attached note sheets. After completing the <br /> evaluation of the information obt fined during the inspection, PHS-EHD may inform you of additional violations. <br /> If any violations are noted, th facility is required to submit a signed Certification of Return to Compliance within 60 <br /> days, unless otherwise speci ed (A certification form is provided). <br /> Failure to correct these violatio s within the scheduled period provided may result in San Joaquin County Public Health <br /> Services-Environmental Health ivision (PHS-EHD) citing you for continuing/additional violations. Issuance of this Inspection <br /> Report does not preclude PHS- HD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> ) 1. r <br /> Environmental Health Specialist Received by Date <br /> Page 1 of=� <br /> 12/9/98 <br /> A Division of San Joaquin County Health Care Services <br />