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SAN O U I Environmental Health Department <br /> _ ........... (: ua I y <br /> Greatness grows here, <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> An inspection checklist was provided to the facility operator at the time of inspection. The EHD will generate <br /> and provide a complete report to the facility operator. <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, within 30 days of receiving the complete inspection report. <br /> Provided: Modified Contingency Plan template, List of Free CUPA Training Classes <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: October 02, 2019 Inspector: Inspector Phone: <br /> Printed Name and Title: ELIANNA FLORIDO, REHS (209)468-0343 <br /> Heather Dela Cruz, Co-Manager <br /> FA0023322 PR0540794 SCO01 10/02/2019 <br /> EHD 22-01 Rev.8/22/2019 Page 4 of 4 Small Quantity Hazardous Waste Generator OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />