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SAN JOAQUIN <br />C C) U i kJ 1 `f <br />Environmental Health Department <br />Small Quantity Hazardous Waste Generator Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />SUTTER GOULD MEDICAL FOUNDATION <br />2545 W HAMMER LN, STOCKTON <br />October 11, 2019 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR = Notice to Comply) <br />Item # <br />Remarks <br />Overall Inspection Comments: <br />An inspection checklist was provided to the facility operator at the time of inspection. The EHD will generate <br />and provide a complete report to the facility operator. <br />Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br />documenting the corrective actions that have been or will be taken for each violation, and any supporting <br />paperwork, within 30 days of receiving the complete inspection report. <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />THIS FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received by: Date: J <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />CLAUDIA MURO, EH Specialist <br />(209) 468-3429 <br />t <br />:.t rs �� �... <br />FA0021375 PR0541469 SC001 10/11/2019 <br />EHD 22-01 Rev. 9/20/2019 Page 4 of 4 Small Quantity Hazardous Waste Generator OIR <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjcehd.com <br />