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PUBL C HEALTH SERVICES <br /> SAN JOAQUIN COUNTY .oG <br /> r <br /> E VIRONMENTAL HEALTH DIVISION <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> 304 E.Weber ve., 3rd Floor • P. O. Box 388 • Stockton, CA 95201-0388 c4�<FOR��P <br /> 209/468-3420 <br /> HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address LIP, S Dot? 4 e:-4 <br /> City State CA Zip Code <br /> EPA I.D.Number <br /> Facility Contact b Phone 6 .19) 7�1 1?" 7� <br /> Consent Given By <br /> Inspection Dates) J Inspection Type (circle): outin Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization - <br /> �P�r�.4 <br /> This report may identify conditio is observed this day that are alleged to be violations of one or more sections of the <br /> California Health and Safety C de (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the <br /> management of hazardous wast . The violations may be described in more detail on the attached note sheets. After <br /> completing the evaluation of th information obtained during the inspection, PHS-EHD may inform you of additional <br /> violations. <br /> If any violations are noted,the f cility is required to submit a signed Certification of Return to Compliance within 60 <br /> days, unless otherwise specifi (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 ivision (PHS-EHD) citing you for continuing/additional violations. Issuance of this <br /> Inspection Report does not precl de PHS-EHD from taking any administrative, civil or criminal action as a result of the <br /> violations noted. <br /> C_/57_4, t 1'.A ) 1. i�►� <br /> Registered Environmental Health Specialist Received by Date <br /> 12/9/94 Page 1 of <br /> A Division of San Joaquin County Health Care Services <br />