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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY _' s <br /> ENVIRONMENTAL HEALTH DIVISION . <br /> Karen Furst, M.D., M.P.H., Health Officer <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 <br /> EPA I.D.Number <br /> Facility Contact latk"\�� ;P. � Phone <br /> Consent Given By <br /> Inspection Date(s) \��\w Inspection Type (circle): Routine Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization <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. <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 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 admi 'strative,civil or criminal action as a result of the violations noted. <br /> A� <br /> vi n I alt �ecia�list � <br /> Received by D to <br /> c <br /> 12/9/98 Page 1 of 5 <br /> A Division of San Joaquin County Health Care Services <br />