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SAN JOAQUIN <br />Environmental Health Department <br />Small Quantity Hazardous Waste Generator Inspection Report <br />11/13/2019 <br />Facility Name: <br />Facility Address: <br />Date: 4 � 20.02' <br />�V <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />Overall Inspection Comments: <br />An inspection checklist was provided to the facility operator at the time of inspection. The inspector <br />will provide a complete report to the facility operator within the next few weeks. <br />Complete and submit a copy of the Return to Compliance Certification form to the EHD with a <br />statement documenting the corrective actions that have been or will be taken for each violation, <br />and any supporting paperwork, within 30 days of receiving the complete inspection report. <br />Documents Provided During the Inspection: <br />- Schedule of Free CUPA Classes <br />- Modified Contingency Plan form <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: 4 Za —207 4 <br />COPY P1L6v«6P <br />Inspector: <br />Inspector Phone: <br />Tb sce'Tr SPR8*j'k ftL 0 WN$R <br />Claudia Muro, EHS <br />Work cell: <br />209-56 -8923 <br />Printed Name and Title: <br />EHD 22-01 Rev. 9/20/2019 Page 4 of 4 Small Quantity Hazardous Waste Generator OIR <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjcehd.com <br />