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R .` <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Unit Supervisors <br /> Donna K.Henan,R.E.H.S. <br /> -:-� 304 East Weber Avenue, Third Floor Carl Borgman,R.E.H.S. <br /> N Director Mike Huggins,R.E.H.S.,R.D.I. <br /> Al Olsen,R.E.H.S. Stockton, California 95202-2708 <br /> Douglas W.Wilson,R.E.H.S. <br /> �•. �c. Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> q�/FORS Laurie A.Cotulla,R.E.H.S. Robert McClellon,R.E.H.S. <br /> Program Manager Fax: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address <br /> City �fGf' State_QA Zip Code <br /> EPA I.D.Number Industry Type bS� <br /> Facility Contact itle- � Phone <br /> Consent Given By I ' Title / I <br /> Inspection Date(s) / (( 3 Inspection Type (circle): Routin Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title /Organization <br /> na <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,you may be informed 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 Environmental <br /> Health Department(EHD)citing you for continuing/additional violations. Issuance of this Inspection Report does not preclude <br /> EHD from taking any administrative,civil or criminal action as a result f the violations noted. <br /> -7/b <br /> vironm al Health Specialist Rece' d by Date <br /> f <br /> 3/5/02 Page 1 of <br />