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San Joaquin County <br /> Environmental Health Departments# , I <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sogov.org/ehd <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> VAN DE POL ENT INC-PRIMARY 4895 S AIRPORT WAY, STOCKTON January 13, 2016 <br /> SUMMARY.OF VIOLATIONS <br /> (CLASS I;CLASS II;or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 103 CCR 66262.34(4)(2) No modified contingency plan. <br /> An emergency coordinator and modified contingency plan information is lacking. There must be at least one <br /> emergency coordinator on site or on call to coordinate emergency response measures, and the following <br /> information must be posted by a phone: the name and phone number of the emergency coordinator; location of fire <br /> extinguishers; spill control equipment, and if present, fire alarm; and the phone number of the fire department, <br /> unless the facility has a direct alarm. Immediately appoint an emergency coordinator and post the required <br /> information by a phone. A form is provided that can be used for this purpose. <br /> This is a minor violation. <br /> 109 CCR 66262.40(a) Failed to keep signed copy of manifests from the designated facility for three years. <br /> Manifest numbers (5/15/13), Ot4@1 8-408JJK(7/8/15), and 014058407JJK-(7/815)were found <br /> without a signed off copy from the destination facility. Manifest numbers 012411721JJKf1/9/14), 04,242 80-34J': <br /> (3/14/14), 013082578JJK'(8/5/14), 013809319JJK/(10/16/14), 014051593JJK'(3/20/15), and_014058236JJK— <br /> (4/16/15)were not found on site. Hazardous waste generators shall retain copies of all manifests signed off by the <br /> destination facility on site for three years and have them readily available for review. If the generator did not receive <br /> a copy of the manifest with the handwritten signature of the owner or operator of the facility to which the generator's <br /> waste was submitted within 60 days of the date the waste was accepted by the initial transporter, the generator shall <br /> submit a legible copy of the missing manifest, with some indication that the generator has not received confirmation <br /> of delivery. This information shall be submitted to: <br /> DTSC Report Repository <br /> Generator Information Services Section <br /> P.O. Box 806 <br /> Sacramento, CA 95812-0806 <br /> Immediately locate a copy of the missing manifests or prepare and submit the required information to DTSC. <br /> Submit to the EHD a copy of the signed off copy of the manifest or a copy of the information submitted to DTSC. <br /> This is a Class II violation. <br /> Received by Inspector: Phone: Date: <br /> (initial): , ELENA MANZO, Senior REHS (209) 953-7699 01/13/2016 <br /> � i1(it Page <br />