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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0514057
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COMPLIANCE INFO
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Last modified
12/19/2024 1:44:12 PM
Creation date
6/23/2020 6:31:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0514057
PE
2226
FACILITY_ID
FA0009836
FACILITY_NAME
MANTECA UNIFIED SCHOOL DISTRICT/be.tech CAMPUS
STREET_NUMBER
2271
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
Ave
City
Manteca
Zip
95337
APN
19811006
CURRENT_STATUS
01
SITE_LOCATION
2271 W Louise Ave
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\HW\HW_2226_PR0514057_2271 W LOUISE_.tif
Tags
EHD - Public
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4 <br />SAN JOAQUIN COUNTY re, <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s'goy.org/ehd <br />Any MINOR violations noted in the "Notice to Comply" in the attached inspection Report must be <br />corrected within 30 days of receipt of this inspection. This certification form .must be submitted to the <br />Environmental Health Department (EHD) address at the top of this form within 30 days of receipt. of the <br />Inspection Report. HSC 25404.1.2(c)(1) <br />All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form, or <br />disputes to any violations, are to be submitted using this certification and returned to EHD within 30 days <br />unless otherwise specified in the Inspection Report. 'HSC 25185(c)(3) <br />Note: All EHD staff time associated with failing to comply by the above noted dates will be <br />billed at the current hourly rate. <br />For this Certification to be complete the operator of the site must include: <br />• A statement documenting what corrective actions were taken or will be taken for each violation <br />• Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos <br />verifying corrections <br />• Operator's certification <br />Inspection Date: Inspected By:_ / h Ji I 'aA <br />(" VOP/ C -A <br />Facility Address:EPA ID#:/� `) 1 6 , ,2 835(,, <br />I certify under penalty of law fhat: <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned <br />inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: <br />Photos 'f_Paperwork Statement <br />3. 1 am authorized to submit this certification on behalf of the Respondent. <br />4. 1 am aware that there are significant penalties for submitting false information, including the <br />posand/or imprisonment for known violations. (HSC 25191) <br />Name:sibi 'ty of a fine Title: b 1,ccdf b(i Ki':-5L <br />jf n-{< <br />, <br />Sianature: 11 ) rte„ �) Date: ?©D <br />EHD 22-02-005 Rev 04/19/12 <br />
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