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_ f IEN T <br /> �. i. ••gyp J6 .� <br /> f <br /> "' M.]�J• JAL �T�T .+'- URtf.47tpt1VtSO rs <br /> 'SANJOA�lJ�1� CarlEorgman,R-E•H.S. <br /> venue,Third Floor M,kc Fi4ggins,RB.Ti.s.,?0�. <br /> �, ppnnalZ.T erati.R.£•H.S. <br /> 30 �8ct�VCber:� 702.Mg D"ZI-,5 W•Vtifr1'°n,R.E.H_S. <br /> •• aim , Director stoccLon,California 9a� hgatgatetLagurio,R.E.F1.S. <br /> plsea,!�•E•H 5• 2p9 46S_3420 ,,bcrtMcCtellon,?E-H-S, <br /> r� �rpyr4mNtana*:r ielepbor - C -0139 1v <br /> . larY gatccllos,R.E::�.S. <br /> h' Lsurie A Cotat'a,F E FI.S. Fa Y: (209)4 <br /> Program hIR�e4er <br /> UNIFIED PROGP.Ia.M <br /> >-tp,Zp,RDOlfs WASTE INSPECTION REPORT <br /> �acllitY NamE <br /> Address State CA.ZIP Code <br /> Ci ,.� �( industry TYPz bsoE <br /> EFA l.D.t`jurnb8r Phone <br /> 5 � Title' <br /> Facility Contact Title <br /> Consent Given BY e circle): Routi Complaint Follow-up <br /> Inspection TyP, <br /> Inspection Dates) <br /> REPRESENTATIVES PRESENT <br /> pranat <br /> Title _ <br /> Name _ <br /> i.s <br /> Of <br /> fol <br /> t are al!aged to be violations of one or more stool►the ma the9erne <br /> ,identify conditions obseriee this day it,ia uittons, <br /> Title 22 (� GCR} relatin,9 lPtir <br /> e she <br /> This report may HSC or the Cai`omia Code of Rag <br /> Health and Safety Code (HSC) descriced in.more detail 'otthheof additional v olati ns After co <br /> U may De informed <br /> hazardous waste• The viotations m$Y the insPectian,Y° <br /> ned Certif Catton of Return to Compliance withii <br /> evaluation of the information obtained during <br /> violations are noted,the facility is required to submit a e <br /> If any provided). <br /> ecitied(A Cert San form is p Environn <br /> days,unless othery'tise sp provided may result to Sapp,°aquin County re, <br /> correct these violations Within the sck,eduled Peed F 4 tions noted. • <br /> re to orti scheaddiCwnal vlotattons• i sv tae of this Ins ction Report does n�F <br /> Faitu these ols,i o yoL far e the <br /> Health Depa-lment{ ) <br /> EHD Eton'►taking any administrative,chit or criminal action as a result o. <br /> D Date <br /> c� 1?tE Recdr'red by . <br /> Environme al Health Sp Ciaiist <br /> Page I of__. <br />