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ENVIRONMENTAL MENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY Unit Supervisors <br /> o..:.. <br /> Carl Borgman,R.E.H.S. <br /> s: ; •, .�"',. '� Donna K.Heran,R.E.H.S. 304 East`Veber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> Director <br /> N:- r Douglas W.Nilson,R.E.H.S. <br /> Al Olsen,R.E.Hs• Stockton, California 95202-270 <br /> P• Program Manager Telephone: (209) 468-3420 1,Aargaret Lagorio,R.E.H.S. <br /> ••c4 _ ;:�� Robert McClellon,R.E.H.S. <br /> F O a Laurie A.Cotulla,RE.H.S. Fax- (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> Program Manager <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address \\�O <br /> �,� State QA.Zip Code �5�0 <br /> City <br /> Industry Type` ,. .-F �� <br /> EPA I.D.Number <br /> �. •"� +'���`� <br /> Phoneme -� <br /> Facility Contact Title <br /> Title r ;;K <br /> Consent Given By <br /> Inspection Date(s)� <br /> o Inspection Type (circle): ome Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Title Organization <br /> Name , c- '� <br /> s <br /> PE'C� SSS <br /> violations management <br /> dents conditions observed this day that are alleged to , Title 22 (22one or more CCR) relating totlons of the the manag m or <br /> This report may identify or the California Code of Regulations, completing <br /> Health and Safety Code (HSC) <br /> ached <br /> te sheets. <br /> hazardous waste. The violations may be described in more detail on the att <br /> you May informed of additional al volutions After com <br /> evaluation of the information obtained during the inspection,Y ance within <br /> violations are noted,the facility is required to submit a signed Certification of Return to Comp • <br /> D <br /> if any <br /> days, unless otherwise specified (A certification form is provided). Joaquin County Environme <br /> may result in San <br /> Failure to correct these violations within <br /> the ng/add scheduled period pro <br /> al tiondedssuance of this nspec <br /> tion Report does not p <br /> rec <br /> Health Department (1_--:H[)) citing you for <br /> inistrative,civil or criminal action as a <br /> EHD from taking any admresult of th solations noted. <br /> Envir n al e pecialist <br /> eceived by Date <br /> Page 1 of 5 <br /> 3/5/02 <br />