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S A J O A Q U I N Environmental Health Department <br /> C0UNT <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> BOURBEAU RANCH 1 16865 GAWNE RD, COLLEGEVILLE May 06, 2022 <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 inspector will provide <br /> 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 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 /> Notes: <br /> Consent to to take photos was not granted during the inspection. <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: May 06, 2022 Inspector: Inspector Phone: <br /> Printed Name and Title: HAZA SAEED, Lead Senior REHS (209)953-6212 <br /> Emailed to Andre Bourbeau, Owner's Son <br /> FA0017426 PR0539887 SCO01 05/06/2022 <br /> EHD 22-01 Rev.12/06/2021 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.sjgov.org/EHD <br />