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C� <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sioov.oro/ehd <br />CONTINUATION FORM <br />Page: 6 of 6 <br />OFFICIAL INSPECTION REPORT <br />Date: 04/17/14 <br />Facility Address: Tower Mart #876 14000 E. Hwy 88 Lockeford, CA 95237 <br />Program: HW <br />SUMMARY OF VIOLATIONS <br />CLASS I, CLASS II, or MINOR -Notice to Comply) <br />812. The operator, Mohammad Siddique stated that universal waste lamps were taken from this facility <br />by Tower Mart technicians for consolidation at the Tower Mart warehouse about three to five months <br />ago. This facility did not keep a record of each shipment of universal waste sent from the universal <br />waste handler's facility to another facility. A universal waste handler shall keep a record of each <br />shipment of universal waste sent from the universal waste handler's facility to another facility. The record <br />may take the form of a log, invoice, manifest, bill of lading or other shipping document. The record for <br />each shipment of universal waste sent shall include <br />the following information: <br />(1) The name and address of the universal waste handler or destination facility to which the universal <br />waste was sent; <br />(2)The quantity [count or weight, consistent with, for example, section 662673.32, subsection (d)] of <br />each type of universal waste sent (e.g., batteries, thermostats, lamps, electronic devices, CRTs, CRT <br />glass); <br />(3) The date of departure of the shipment of universal waste. <br />A universal waste handler shall retain each record for at least three years. <br />Correct immediately by keeping a record of each shipment of universal waste for three years. <br />Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br />each violation was corrected, including supporting documentation, by 5-17-14. <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: ,{ iN / <br />Aris Veloso (209) 468-3453 ��OtlfT <br />Re ive By: <br />Title: <br />EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />