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HEALTH SERVICES �0�: ; <br /> PUBLIC 2:. <br /> SAN JOAQUIN COUNTY I <br /> ENVIRONMENTAL HEALTH DMSION <br /> Karen Furst, M.D., M.P.H., Health Officer c��.�o ,�� <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 /> city mayam m State CA Zip Code <br /> EPA I.D.Number <br /> Facility Contact <br /> Ufa/D �,I1� Phone <br /> Consent Given 13 <br /> Inspection Date(s) Inspection Type (circle): outine Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Title Organization <br /> Name <br /> D � M <br /> This report may identify conditions observed this a Code of Regare ulattito iionn , Title 22 (22 ations fone or more CCR) relating totlons of the the management <br /> Health and Safety Code (HSC) or the California <br /> hazardous waste. The violations may be the in described <br /> attached in more detail on the completing the <br /> tion PHS-EHD may inform you of additional violations. <br /> ons. <br /> evaluation of the information obtained during the sp <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 /> uin <br /> unty <br /> lic Heal"71 <br /> Failure to correct these violations within the scheduled P ou for continuing/additional tionmay lallviolationsn San alssuance of thislnspecto''-' <br /> Services-Environmental Health Division (PHS EHD) citing y <br /> Report does not preclude PHS-EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> 111L'i AaJ— <br /> Environmental 4HehSpecial t <br /> "Received Date <br /> Page 1 of <br /> 12/9/98 , <br /> A Division olrSan Joaquin County Health Care Services <br />