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PUB 100HEALTH S <br /> POUIiy <br /> SAN JOAQUIN COUNTY <br /> 'O l........,n <br /> . <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Ernest . Fujimoto, M.D., M.P.H., Acting Health Officer •) <br /> 304 E.V1 ebe Ave., 3rd Floor • P. O. Boa 388 • Stockton, CA 95201-0388 <br /> 209/468-3420 q� F O <br /> HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address A <br /> City State CA Zip Code 76Z-4,-�o <br /> EPA I.D.Number <br /> Facility Contactr � %iii;�' Phone <br /> Consent Given By <br /> Inspection Date(s) /i i > Inspection Type (circle): outi Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organizatign <br /> This report may identify Condit ons observed this day that are alleged to be violations of one or more sections of the <br /> California Health and Safety Qode (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 t e 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 iDivision (PHS-EHD) citing you for continuing/additional violations. Issuance of this <br /> Inspection Report does not preclude PHS-EHD from taking any administrativ jqi4 r 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 DiNision of San Joaquin CountN Health Care Services <br />