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S A J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> JACOBS MALCOLM &BURTT 645 N STOCKTON ST, LODI JUIy 20, 2022 <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: July 20, 2022 Inspector: Inspector Phone: <br /> Printed Name and Title: HAZA SAEED, Lead Senior REHS (209)953-6212 <br /> Emailed to Fransisco Rangel, Food Safety Manager <br /> FA0010451 PR0540586 SCO01 07/20/2022 <br /> EHD 22-01 Rev.12/06/2021 Page 6 of 6 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 />