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ENVI ONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> �•• =s��'.qG Unit Supervisors <br /> Donna K.Her n,R.E.H.S. Carl Bor man,R.E.H.S. <br /> 304 East Weber Avenue, Third Floor g <br /> Direc or Mike Huggins,R.E.H.S.,R.D.I. <br /> 1 Al Olsen, .E.H.S. Stockton, California 95202-2708 Douglas w.Wilson,R.E.H.S. <br /> • �.., c• Program anager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> 9�%FORC1� <br /> Laurie A.Cotu la,R.E.H.S. Fax: (209) 464-0138 Robert McClellon,R.E.H.S. <br /> Program anager Mark Barcellos,R.E.H.S. <br /> UNIFIED ROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name <br /> Address / <br /> City State CA.Zip Code <br /> EPA I.D.Number L (4C) Industry Type GSA S' <br /> Facility Contact / Title' 9Z ;&225e Phone <br /> Consent Given By Title <br /> Inspection Date(s) Inspection Type (circle) ROutioe Complaint Follow-Up <br /> REPRESENTATIVES PRESENT <br /> Name Title Organization <br /> This report may identify condition observed this day that are alleged to be violations of one or more sections of the California <br /> Health and Safety Code (HSC) r the California Code of Regulations, Title 22 (22 CCR) relating to the management of <br /> hazardous waste. The violation may be described in more detail on the attached note sheets. After completing the <br /> evaluation of the information obtai ed during the inspection,you may be informed of additional violations. <br /> If any violations are noted, the acility is required to submit a signed Certification of Return to Compliance within 60 <br /> days, unless otherwise specifie (A certification form is provided). <br /> Failure to correct these violation within the scheduled period provided may result in San Joaquin County Environmental <br /> Health Department (EHD) citing y u for continuing/additional violations. Issuance of this Inspection Report does not preclude <br /> EHD from taking any administrati civil or criminal action as a result of the violations noted. <br /> 6 <br /> Environmental Health Specialist Received by D e <br /> 3/5/02 Page 1 of <br />