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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Unit Supervisors <br /> Donna K.Heran,R.E.H.S. Carl Borgman,R.E.H.S. <br /> Director 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> QI-i Fo'R`' Laurie A.Cotulla,R.E.H.S. Fax: (209) 464-0138 Robert McClellon,R.E.H.S. <br /> Program Manager Mark Barcellos,R.E.H.S. <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> C <br /> Facility Name <br /> Address q <br /> City " <br /> State CA Zip Code 2 <br /> EPA I.D.Number <br /> Industry Type <br /> Facility Contact 1 <br /> Title _Phone-3a,_- L1 <br /> Consent Given By '����� C Title <br /> Inspection Date(s) Inspection Type (circle)- Routin Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Nfir} Title Org�g tiOn <br /> a�l � �7 ilt- <br /> � t'•*k, ��r ^�, ,vis-r..� r�cr r�- n� - _ <br /> or <br /> This report may identify conditions observed this day that are alleged to be viol 22ns22f one relating tomore titheon of the Cmleotnia <br /> Health and Safety Code (HSC) or the California Code of Regulations, Title <br /> of <br /> hazardous waste. The violations may be describedn more detail on <br /> you may be informattached ed a of additional a vio sheets. <br /> .After completing the <br /> inspection,evaluation of the information obtained during the Y <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 <br /> period <br /> violationprovided <br /> assuance of this Inspection not preclude <br /> in County Environmental <br /> Health Department(EHD)citing you for continuing/additional <br /> EHD from taking any administrative,civil or criminal action as a esult of the violations noted. <br /> / v <br /> V <br /> Anvironmjenta'i- <br /> Health Sp Qi lis '3 <br /> Received by 4De <br /> Page 1 of <br /> 3/5/02 <br />