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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DMSION <br /> Karen Furst, M.D., M.P.H., Health Officer ' .. <br /> 304 East Weber Avenue, Third Floor• Stockton, CA 95202 <br /> �� FORN`P <br /> 209/468-3420 <br /> UNIFIED <br /> /PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> WX �� <br /> Facility Name � �• /lrt. ��1� <br /> Address 6'07 eE 11-6 <br /> City Q State CA Zip Code 76 <br /> EPA I.D.Numberl/goeld(a <br /> Facility Contact �/1 �L'!1 S�Ci//� Phone tS J'c 'D <br /> Consent Given By ✓/ ) ���'P l T Syr1 <br /> Inspection Date(s) 3 /�� Inspection Type (circle): Routi Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title" � Organization <br /> �f YGI ©�,vrurli ( 4�f �i�FSC( x A":k <br /> This report may identify conditions observed this day that are alleged to be violations of one or more sections of the California <br /> Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of <br /> hazardous waste. The violations may be described in more detail on the attached note sheets. After completing the <br /> evaluation of the information obtained during the inspection, PHS-EHD may inform you of additional violations. <br /> If any violations are noted, the facility is required to submit a signed Certification of Return to Compliance within 60 <br /> days, unless otherwise specified (A certification form is provided). <br /> Failure to correct these violations within the scheduled period provided may result in San Joaquin County Public Health <br /> Service -Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this Inspection <br /> Repo does n5ea <br /> ude PHS-EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> AenSpecialist Received by Date <br /> 12/9/98 Page 1 of <br /> A Division of San Joaquin Counry Health Care Services <br />