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r'�' ;i « "�� d .i` ?."i�r rte+ t : iL s.s • <br />i <br />Environmental Health Department <br />SAN JDAQUIN <br />---- C O U N I <br />Hazardous Materials Program Inspection Report <br />Facility Name: <br />Facility Add ss: _# <br />Date,: <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to comply) <br />Item # Remarks <br />Overall Inspection Comments: <br />An inspection checklist was provided to the facility operator at the time of inspection. The inspector will provide <br />a complete report to the facility operator within the next few weeks. . <br />CmmtilPtP nnrl cit}imit a rnnv of tba DR f,,rn 1-n 1'^.Y„-.1;.,., o (e.+;fi +: F,. + +L rwr% . ,;+, + t F <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: /-Z <br />Inspector: <br />i I S/) -U Inspector Phone: <br />Printed Name and Title: t4" <br />! \IhPL�V41/ Ne AJJ�) 'iS� M � ��VJJV'� 1 t t VI l ICJ I � 3 V Ci - <br />EHO t"t Rev, 12/MO21 Page 2 of 2 Hazardous Matedals Program OIR <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />