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ENVIRONMENTAL HEALTH DEPARTMENT <br /> PQ'u l"•C SAN JOAQUIN COUNTY Unit Supervisors <br /> Carl Borgman,R.E.H.S. <br /> Donna K.Heran,R.E.H.S. 304 East Weber Avenue, Third Floor <br /> Director Mike Huggins,R.E.H.S.,R.D.I. <br /> ; Californiaouglas W.Wilson,R.E.H.S. <br /> Al Olsen,R.E.H.S. Stockton, alifornia 95202-2708 <br /> `• .P <br /> Program Manager Telephone: (209) 468-3420 Margaret La orio,R.E.H.S. <br /> • cq�i Fo'arLaurie A.Cotulla,R.E.H.S. Robert McClellon,R.E.H.S. <br /> Fax: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> Program Manager <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address t`C <br /> City <br /> t' State CA..Zip Code <br /> EPA I.D.Number <br /> Industry Type <br /> Facility Contact Title M h ut n %0 Phone <br /> --� <br /> Consent Given By <br /> �o Title <br /> Inspection Dates) f2� utin Inspection Type (circle): Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> ITitle Organiz t <br /> ion <br /> Nam ? I <br /> This report may identify conditions observed this day that are alleged to be violations <br /> 22f one or relating more secthetions <br /> of the California <br /> tnia <br /> Health and Safety Code (HSC) or the California Code of Regulations, Ti <br /> tle of <br /> hazardous waste. The violations may be described in more <br /> tail on the attached noinformed of additional vio sheets. <br /> ,After completing the <br /> tionyou may evaluation of the information obtained during the inspection,y Y <br /> If any <br /> 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 /> in County Environmental <br /> Failure to correct these violations within the scheduled Pa110 olat ones edlssuance of this s nspectionmay result in San uReport does not preclude <br /> Health Department(EHD)citing you for continuing/addition <br /> EHD from taking any administrative,civil or criminal action as a r suit of the violations noted. <br /> 3 <br /> Environmental Health Spec ist <br /> Received by Date <br /> -Pagel of <br /> 3/5/02 <br />