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ter' San Joaquin County -� <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sigov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> ,LLLY FORKLIFT ;31 E FREMONT ST, STOCKTON 1,july 02 2015 <br /> paperwork, by 8/1/2015 <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials information <br /> online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be sure to include <br /> your hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THEAB VE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Receiv I1 Received By(printed name and title): Date: <br /> (signatu Julie Woods, Safety <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): JAMIE DE LA ROSA, HM Specialist II 209) 953-62 <br /> Page 2 of 2 <br />