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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 eP . <br /> 7�iFOR~\ <br /> 304 East Weber Avenue,Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> � <br /> Facility Name c <br /> Addressfv� r IV ' <br /> City 'S �/�T " " _ State CA Zip Code <br /> EPA I.D.Number Cl�L 000 15 � 0 p -- <br /> W 9 �16 � <br /> Facility Contact Jof-(— Phone <br /> Consent Given By <br /> Inspection Date(s) Z ©d Inspection Type (circle): Ro e Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> NaTijo Title rg nation <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 /> Failur to correct these violations.within the scheduled period provided may result in San Joaquin County Public Health <br /> Aviro <br /> Environm I Health Divsion (PHS-EHD) citing you for continuing/additional violations. Issuance of this Inspection <br /> es not p cl e PHS-EHD from taking any administrative,civil or crimin tion as It of the violations noted. <br /> t <br /> e I alt Specia is eived by Da e <br /> 12/9/98 Page 1 of_ <br /> A Division of San Joaquin County Health Care Services <br />