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PUBLIC r-1EALTH SERWCES <br /> SAN JOAQUIN COUNTY ? <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer • cq., {P <br /> Ce <br /> 445 N. San Joaquin Street • P.O. Box 388 0 Stockton, CA 95201-0388 tE <br /> (209) 468-3420 <br /> HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name S t 1 , �1iCln ; &)q <br /> Address <br /> City �'�r k_Ar K. , State CA Zip Code GSZI S <br /> EPA I.D.Number <br /> Facility Contact QA,) rJCtutz Phone <br /> Consent Given By d►J �fYN l Q AEz <br /> Inspection Date(s) 'V/Q' Inspection Type (circle): Routin Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization <br /> �F ► kms NS - i; {if) <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 /> d+zrf7i -2-72 <br /> Registered Environmental Health Specialist Received by Date <br /> 1219/94 Page 1 of <br /> 4 Dkkiun nltion Joaquin(bunt} Health care senire. <br />