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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.sjgov.org/ehd <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: acility Address: Date: <br /> VAN DE POL ENTERPRISES INC T181116 E FRONTAGE RD. RIPON January 25, 2016 <br /> Overall Inspection Comments: <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, by February 24, 2016. <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials <br /> information online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be <br /> sure to include your hazardous waste activity in the Businesses Activities section in CERS in addition to any <br /> other relevant activities and required fields. <br /> Documents reviewed: Disposal records, modified contingency plan <br /> Documents provided: Return to Compliance Certification form, Schedule of free CUPA classes, Modified <br /> contingency plan template <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> T IS FACILITY BACK INTO COMPLIANCE <br /> THIS F ILIT T J CT REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received B Received By(printed name and title): Date: <br /> (signature): 4" Ted Shackelford, Operator —�Cj—)�ij <br /> Inspector Inspector(printed name and title): I <br /> pector Phone: <br /> (signatu STACY RIVERA, Senior REHS (209)468-3440 <br /> Page 5 of 5 <br />