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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sogov.org/ehd <br /> CONTINUATION FORM Page: 5 of 5 <br /> OFFICIAL INSPECTION REPORT Date: 7/29/2014 <br /> Facility Address: 515 W. Eleventh, Tracy Program: HW <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Complete and submit a c py of the Return to Compliance Certification form with a statement of how <br /> each violation was correct d, including supporting documentation, by August 29, 2014. <br /> Note: A box of fluoresce t tubes (9) were seen next to the dumpster. Reviewed storage and disposal <br /> options with manager. PI ase provide this office with a copy of the disposal receipt for the bulbs. <br /> ALL EHD STAFF TIME SSOCIAT D WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILI IS SU ECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: Title: <br /> 209) x ._ r <br /> EHD 23-02-003 Rev 04/19/12 �� � J CONTINUATION FORM <br />