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r ' �' ;«"�� d .1` ? 'i�r ram+t :iL s.s• <br /> i <br /> Environmental Health Department <br /> SaN JDAQUIN <br /> ----C O U N I <br /> Hazardous Materials Program Inspection Report E_ <br /> � . <br /> Facility Name: Facility Add ss: � Date: <br /> SUMMARY OF VIOLATIONS as <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) ;_. <br /> Item# Remarks Ir. <br /> i.• <br /> L� <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 /> N <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: f Inspector: <br /> 1 I /2 S/)-U Inspector Phone: <br /> Printed Name and Title: t4" <br /> ! \IhPL�V41/ NeS� ��VJJV'�1 i� i VI l� 0/lo 3t� - <br /> EHD 1"I Rev,ttiMenort Page 2 of 2 Hazardous Matedals Program 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 />