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�oo4'M' 00 <br />PUBLIC IfEEALTH SERVeCCES <br />SAN JOAQUIN COUNTY e <br />ENVIRONMENTAL HEALTH DIVISION <br />Karen Furst, M.D., M.P.H., Health Officer4 �P <br />304 East Weber Avenue, Third Floor - Stockton, CA 95202 <br />209/468-3420 <br />UNIFIED PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br />Facility Name <br />Address <br />City State CA Zip Code 21 f2Z)4 <br />Facility Contact W J Phone !f - 6 <br />Consent Given By <br />Inspection Date(s) m Inspection Type (circle):Routi Complaint Follow -Up <br />Name Title Organization <br />S( <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. O <br />If any violations are noted, the facility is required to submit a signed Certification of Return to Compliance within""9& <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 />Report does not preclude PHS-EHD from taking any administrative, civil or criminal action as a result of the violations noted. <br />e <br />COMO' <br />Environmental Health Specialist Received by Date <br />12/9/98 Page 1 of <br />A Division of San Joaquin County Health Care Services <br />