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• 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.siaov.ora/ehd <br /> CONTINUATION FORM Page: 2 of 2 <br /> OFFICIAL CTION REPORT 12/31/13 <br /> Facility Address: 4989 S Hwy 99, Stockton, CA 95215 Program: HM <br /> SUMMARY OF VIOLATIONS <br /> CLASS I CLASS II or MINOR-Notice to Comply) <br /> Continued: <br /> 2. Submit a CERS Lead User form provided at the time of inspection for your facility to the <br /> Environmental Health Department. <br /> 3. Complete and return the Return to Compliance form with proof the corrections have been <br /> completed by January 31, 2014. <br /> Note, you are required to update your CERS account within 30 days of making a change to your <br /> Business Plan, Chemical Inventory or Site Map. <br /> Photos taken and provided to manager at the time of inspection. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE 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 /> EHD Inspector:^ Received By: Title: <br /> `Jobe, La e--Zkm- <br /> CONTINUATION FORM <br /> EHD 23-02-003 Rev 04119/12 <br />