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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DMSION -I <br /> Karen Furst, M.D., M.P.H., Health Officer +� Foams <br /> 304 East Weber Avenue,Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address <br /> �_ State CA Zip Code <br /> City ! Al r`(']\ <br /> EPA I.D.Number <br /> cloj- <br /> Facility Contact <br /> I I 1 Ip Phone <br /> Consent Given By <br /> Inspection Date(s) 1 q / Inspection Type (circle): outin Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Title Organization <br /> N me ��tS <br /> S <br /> It <br /> This report may identify conditions observed this day that are alleged to be violations of one or more sections of the Cali`orni=_ <br /> Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management o <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 6C <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 Hdie <br /> Services-Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this Insp_ <br /> Report does not preclude PHS-EHD from taking any administrative,civil or criminal action as a result of the violations not=_d. <br /> Environme th I HealSpe ialist <br /> Received Date <br /> Page 1 of <br /> 12/9/98 <br /> A r)ivieion orSan Joaquin County Health Cam Services <br />