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PUBLIC HEALTH SERVICES <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />Facility Name <br />Address <br />Karen Furst, M.D., M.P.H., Health Officer <br />304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br />209/468-3420 <br />UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br />f <br />I(A <br />City ST�a'Z State CA Zip Code <br />EPA I.D.Number r%'(_1C' 00 / 6 3 <br />Facility Contact <br />Consent Given By <br />_Phone (6 G 7 7 �l / <br />PQU1N <br />w:. r <br />'� C � F O•FRe� <br />Inspection Date(s) 3 Inspection Type (circle): Routine Complaint Follow -Up <br />REPRESENTATIVES PRESENT <br />N Title Or ni ation <br />This report may identify conditions observed this day that are alleged to be violations of one or more sections of the California <br />Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of <br />hazardous waste. The violations may be described in more detail on the attached note sheets. After completing the <br />evaluation of the information obtained during the inspection, PHS-EHD may inform you of additional 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 Inspection <br />Inron <br />rt` oes not pr ude PHS-EHD from taking any administrative, civil or criminal action as a resu of the violations noted. <br />ntal Health Specialist 4eceived by D t <br />12/9/98 <br />A Division of San Joaquin County Health Care Services <br />Page 1 of <br />