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SAN <br />, OAQ U I N Environmental Health Department <br />CP22 - HMBP Inspection Report <br />Date: <br />22 1025 - Training - General Local Ordinance ❑ OUT ❑ R ❑ COS <br />23 See below 1030 - Operations/Maintenance - General ❑ OUT ❑ R ❑ COS <br />24 1035 - Operations/Maintenance - General Local Ordinance ❑ OUT ❑ R ❑ COS <br />25 See below 1040 - Release/Leaks/Spills - General ❑ OUT ❑ R ❑ COS <br />26 See below 1045 - Release/Leaks/Spills - General Local Ordinance ❑ OUT ❑ R ❑ COS <br />27 See below 1050 - Abandonment/Illegal Disposal/Unauthorized Treatment - General ❑ OUT ❑ R ❑ COS <br />28 See below 1055 - Abandon ment/IIlegal Disposal/Unauthorized Treatment - General Local Ordinance ❑ OUT ❑ R ❑ COS <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS Il, 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 a <br />complete report to the facility operator within the next few weeks. Complete and submit a copy of the Retum to <br />Compliance Certification form to the EHD with a statement documenting the corrective actions that have been or <br />will be taken for each violation, and any supporting paperwork, within 30 days of receiving the complete inspection <br />report. <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING THIS <br />FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHUS CURRENT HOURLY RATE. <br />Received by: Date: Inspector: Inspector Phone: <br />Printed Name and Title: / <br />EHD Rev. 12/0612021 Page 2 of 2 <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 />