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PUBLIC HEALTH SERVICES <br />r SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DMSION <br />Facility Name <br />Address <br />Karen Furst, M.D., M.P.H., Health Officer <br />304 East %}Veber Avenue, Third Floor • Stockton, CA 95202 <br />209/468-3420 <br />UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br />rd] <br />City <br />v `� <br />State CA Zip Code i2�— <br />C�FOR. <br />EPA I.D.Number CykL- Lon <br />��oy)n 5 R Phone (.lt'o_ aN5-1?092 <br />Facility Contact � � t � � w� <br />Consent Given By wa «c <br />Inspection Dates) �a�- Inspection Type (circle): Routine omplaint Follow -Up <br />REPRESENTATIVES PRESENT <br />Titlo <br />Organization <br />VHS -e, <br />• 1 ..Il <br />A-V...fi.l� <br />one or mo <br />resections <br />This report may identify conditions observed daythat are <br />of Reg allege <br />latons, Title/ations 22 (22 of <br />CCR) relating to managCmen�tno' <br />Health and Safety Code (HSC) or the California <br />hazardous waste. The violations may be described in more detail on the attached note sheets. After completing <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 6C <br />days, unless otherwise specified (A certification form is provided). <br />Failure to correct these violations within the scheduled period provided may result in San Joaquin County Public Hea!_* <br />ional Services -Environmental Health Division (PHS-EHD) citingyou nistr fore civil or criminal action asta resullt of the violassuance oil tionis s no =d�o' <br />it <br />Report does not preclude PHS-EHD from taking any a <br />1 L-3-20061 <br />Z2�Z <br />Environmental H alt Speciaoist <br />Aecived by Date <br />Page 1 of �Q <br />12/9/98 <br />n:..:.: „C c,., Tnaauin Counry Health Care Services <br />