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NI <br /> 10 18 Environmental Health Department <br /> SAN 10AQUIN <br /> CC ) UN i Y <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address : Date: <br /> SALVATION ARMY ADULT REHAB 1247 S WILSON WAY, STOCKTON October 25 , 2018 <br /> appointment , please call (209) 468-3420 . <br /> Waste streams observed : e-Waste , Universal Waste , Antifreeze/Coolant <br /> Inspector provided RTC Certification , Flyer for free CUPA Classes and Modified Contingency Plan Template . An <br /> inspection report was provided to the facility operator on the day of inspection . The report was amended by the <br /> EHD . <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 amended 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 : Inspector: Inspector Phone: <br /> Printed Name and Title : TRICIA DAI , EHS Trainee (209) 468-0331 <br /> FA0003949 PR0541457 SC001 10/25/2018 <br /> EHD 22-01 Rev. 09/27/2018 Page 6 of 6 Small Quantity Hazardous Waste Generator OIR <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 I www, sjcehd . com <br />