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PUBLICn' SERVICES <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />Ernest M. Fiu,jimato, M.D., M.P.H., Acting Health Officer <br />304 E,Weber Ave., 3rd Floor • P. O. Box 388 a Stockton, CA 95201-0388 c4C,Fau-4 <br />209/468-3420 <br />HAZARDOUS WASTE INSPECTION REPORT <br />I _ - I - - I I, I f'�ion'j <br />Facility Name <br />Address <br />State CA Zip Code <br />City • �' <br />EPA I.D.Number p -z, <br />Phone <br />Facility Contact _'�'`"'�� �'`�" <br />Consent Given By <br />inspection Date(s) Z //z2L_�� <br />'inspection Type (circle): �outi*Complaint Follow -Up <br />REPRESENTATIVES PRESENT <br />Name Title Organization <br />_sS•Gy.PRla�' <br />This report may identify conditions observed this day that are alleged to be violations of one or more sections of the <br />California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the <br />management of hazardous waste. The violations may be described in more detail on the attached note sheets. After <br />completing the evaluation of the information obtained during the inspection, PHS-EHD may inform you of additional <br />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 />Services -Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this <br />Inspection Report does not preclude PHS-EHD from taking any administrative, civil or criminal action as a result of the <br />violations noted. <br />Registered Environmental Health Specialist Receiv by Date <br />Page 1 of <br />1219/94 <br />8 Division of San .Joaquin County Health Care Services <br />F <br />CRIC'T' <br />