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PUBLI HEALTH SERVICES <br /> SAN JOAQUIN COUNTY ' z� <br /> RONMENTAL HEALTH DIVISION <br /> en Furst, M.D., M.P.H., Health Officer , :P <br /> 304 Easi Weber Avenue, Third Floor• Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address ZZ S <br /> City ��� State CA Zip Code 9s'_3 76p, <br /> EPA I.D.Number <br /> Facility Contact Phone c2Oq <br /> Consent Given By 7? <br /> Inspection Date(s) l� Inspection Type (circle): Eutine_. omplaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> ,Na a Title 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 violatio s may be described in more detail on the attached note sheets. After completing the <br /> evaluation of the information obt ined 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 specifi d(A certification form is provided). <br /> Failure,ito correct these violatio s within the scheduled period provided may result in San Joaquin County Public Health <br /> Servi s-Environmental Health ivision (PHS-EHD) citing you for continuing/additional violations. Issuance of this Inspection <br /> Rep _does not preclude PHS-E ID from taking any administrative,civil or criminal action as a result of the violations noted. <br /> nvi en t Specialist Received by Date <br /> 12/9/98 Page 1 of <br /> A Division of San Joaquin County Health Care Services <br />