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ENVIRONMENTAL HEALTH DEPARTMENT <br /> PQU.!N SAN JOAQUIN COUNTY Unit Supervisors <br /> Carl Borgman,R.E.H.S. <br /> 2' 3 '•.. '? Donna K.Heran,R.E.H.S. <br /> 304 East Weber Avenue,Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> Director <br /> -s Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> 'c: `P• Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> IF 60 Laurie A.Cotulla,R� R.E.H.S. Fax: <br /> 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 /> c <br /> Address q <br /> State QA Zip Code <br /> city1 <br /> tuber Industry Type Low lZ� � <br /> EPA I.D.Nu /► <br /> Facility Contact <br /> itle -Phone_L <br /> Consent Given By �� <br /> �Nc�1 Title <br /> Inspection Date(s) <br /> Inspection Type (circle): QRouti Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Title Organi a <br /> tion <br /> Name � �f1 S <br /> 74 <br /> r-o <br /> to be violations <br /> one or more <br /> ons of the <br /> rnia <br /> This report may identify conditions observed this day that of Reare gulations, Title 22 (22f CCR) relating tot'the management of <br /> Health and Safety Code (HSC) or the California Co 9 <br /> hazardous waste. The violations may be described in .more detail on the attached note sheets. After completing the <br /> inspection,you may informed of additional violations: <br /> evaluation of the information obtained during the <br /> If any violations are noted,the facility is required to submit a signed Certification of Return to Compliance within 6( <br /> days,unless otherwise specified(A certification form is provided). <br /> in County <br /> ironmentE <br /> Failure to correct these violations within the scheduled P1violations. assuance of this nspectionmay result in San uReport dols nvot precI <br /> Health Department(EHD)citing you for continuing/additional <br /> EHD from taking any administrative,civil or criminal action as a result of the violations noted. <br /> Environmen al Health Sp cialist <br /> Rec ived by Date <br /> Page 1 of <br /> 3/5/02 <br />