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PUBLIC HEALTH SERVICES ,oPR�IN. <br /> SAN JOAQUIN COUNTY r' <br /> ENVIRONMENTAL HEALTH DMSION <br /> Karen Furst, M.D., M.P.H., Health Officer • a.. P. <br /> 304 East Weber Avenue,Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name SI I lC 11TLl,M1aA2 1 &t V(IS <br /> Address 41M POU'L, Wwrl <br /> City MA Y�Ai ea State CA Zip Code 6f5 33-I <br /> EPA I.D.Number IAT ODD &4[o[o 192 <br /> Facility Contact bill PCICe Phone <br /> Consent Given By ?n&. <br /> Inspection Date(s) I _C(`�I Inspection Type (circle): Routine Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization <br /> il�� �.I <br /> �r i C D a t�l�blmd:Fm I rcnX1 <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 /> Services-Environmental Health Division (PHS-EHD) citing you for continuing/additional violations. Issuance of this Inspection <br /> Report does not preclude PHS-EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> C�1�-ped rn� <br /> Environmentaleal h S ci ist Received by Date <br /> 12/9/96 Page 1 of 5 <br /> A Division of San Joaquin County Health Care Services <br />