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PUBLIC- HEALTH SER-Y'ICES pG1UlN <br /> SAN JOAQUIN COUNTY Z..'C9 <br /> c°Z <br /> •� <br /> ENVIRONMENTAL HEALTH DIVISION r <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> 304 E.Weber Ave., 3rd Floor • P. O. Box 388 • Stockton, CA 95201-0388 c44�iFijR�•P <br /> 209/468-3420 <br /> HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address <br /> City �� v, State CA Zip Code <br /> EPA I.D.Number c--7- tz7c 7 <br /> Facility Contact _-O a -A Phone 466 <br /> Consent Given By a v'4 -7-a.'E_"l' <br /> Inspection Date(s) 3 Inspection Type (circle): outin)e Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization <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 Received by Date <br /> 12/9/94 Page 1 of <br /> .A Division of San Joaquin County Health Care Services <br />