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OI®1I�IENTAL HEALTH. DEPARTMENT <br /> ENVI <br /> Pa�,N SAN JOAQUIN COUNTY Unit Supervisors <br /> Carl Borgman,R.E.H.S. <br /> Third Floor <br /> 304 East Weber Avenue, <br /> _? 9? Donna K.Her n,R.E.H.S. Mike Huggins,R.E.H.S.,R.D.I. <br /> Dire for California 95202-2708 <br /> StoclCtOri, Douglas W.Nilson,R.E.H.S. <br /> Al Olsen, .E.H.S. Mar aret Lagorio,R.E.H.S. <br /> ' P• Program Tanager Telephone: (209) 468-3420 Robert McClellon,R.E.H.S. <br /> Laurie A.Cot ilia,R.E.H.S. Fax: (209) 464-013$ Mark Barcellos,R.E.H.S. <br /> Program Vanager <br /> UNIFI D PROGRAM HAZARDOUS WASTE INSPECTION REPORT <br /> Facility Name i <br /> Address <br /> { .� State SA.Zip Code <br /> City <br /> IndustryType <br /> EPA I.D.Number q <br /> Facility Contact <br /> � i'����G�_�'� Title �;yr.� Phone <br /> Title <br /> Consent Given By <br /> e circle outine Complaint Follow-Up <br /> Inspection Date(s) <br /> Inspection Typ ( ) <br /> REPRESENTATIVES PRESENT <br /> Organization <br /> Name Title <br /> ' ons observed this day that are alleged to be violations of one or more sections of the California <br /> Title 22 (22 CCR) relating to the management of <br /> This report may identify c nditi feting thF <br /> Health and Safety Code (HSC) or the California Code of Regulations, <br /> e attached note sh e <br /> hazardous waste. The violations may be described in.more detail 'on tion,you may be informed of additional violations.After comp <br /> evaluation of the informa ion obtained during the inspection,Y fiance within 6c <br /> if any violations are no ed,the facility is required <br /> � submit <br /> i bmovided) ed Certification of Return to Comp <br /> days,unless otherwise specified (A certification p aqin County Environment <br /> Failure to correct these violations within the scheduledperiod <br /> p onsmay result suance of this nspectionuReport does not preclud <br /> in San Jo <br /> Health Department(EH ) citing you for continuing/additional <br /> EHD from taking any ad inistrative,civil or criminal action as a result of the violations noted. <br /> L LReceived by Date <br /> Environmental Health Specialist <br /> Page-1'of <br /> 3/5102 <br />