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HAZARDOUS MATERIALS <br /> MANAC <br /> • ;� EMENT <br /> REPORT <br /> State of Califonua ✓�M /dt��rf <br /> Department of Health Services <br /> Hazardous Materials Management Section p�� '739 3X41— <br /> 2151 llcrkeley Wjjy,Berkeley <br /> ?� 94704 <br /> Date (415) 540.2043 <br /> . . . <br /> 1449 W.Ten,plr Sr.,Los AngcJcs 900 <br /> (213)620.2380 <br /> Firm Name ��,�� l7L�Sl�},?� e <br /> Site Permit No. <br /> Address lZ.9 <br /> Site Classification: <br /> J <br /> Person Interviewed /�j�.� � a�ti �❑ I El II-1 El 11-2 <br /> Other ❑ 111 <br /> X13 <br /> On this date an inspection of your facility was conducted under authority of Section 2S1 <br /> Safety Code and Section 66328, California Administrative Code. The collection o <br /> including the taking of photographs, war done under authorityo 8e California Health £, <br /> The following conditions or practices observed this date are alleged to be v f samples or other evidence, <br /> California Health fr Safety Code, Division observed <br /> or Californiaea f Section 6 violations <br /> s of Otte <br /> moridme sections Code. <br /> 8 solations of one or more sections of the <br /> Iwndli,+g, transportation, anddministrative disposal of hazardous and extr mely hazardous wase Title <br /> �toslcontai,�rthe storage, <br /> g products. <br /> e — <br /> � v <br /> J, - <br /> � S <br /> �r <br /> C-o .Y ��l• <br /> l./1 <br /> 7 f � <br /> Y <br /> Y r signature ac wledges receipt o <br /> P f a copy of this report and collection of any samples <br /> Authorized Repr>s described above. <br /> Name <br /> Title: E� <br /> o w n/ -. <br /> Authorised Agum <br /> EH 202(7/78) <br /> �.� <br /> a;r Page— of J <br />