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SAN" J D�l+ �� I 1411" Environmental Health Department <br /> COUNTY�l <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CEMEX CONST MATERIALS PACIFIC LLC 30350 S TRACY BLVD TRACY July 03 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 111 CCR 66262.42(a)(c)(d)Failed to comply with uniform hazardous waste manifest exception requirements. <br /> The following manifest numbers were found without a signed off copy from the destination facility: <br /> -016869623JJK(5.10.17) <br /> -017467557JJK(5.11.18) <br /> -018529390JJK(9.13.18) <br /> -016868804JJK(3.25.19) <br /> Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three <br /> years and have them readily available for review. If the generator did not receive a copy of the manifest with the <br /> handwritten signature of the owner or operator of the facility to which the generator's waste was submitted within 60 <br /> days of the date the waste was accepted by the initial transporter, the generator shall submit a legible copy of the <br /> missing manifest,with some indication that the generator has not received confirmation of delivery. This information <br /> 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. Submit <br /> 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 repeat violation, Class II. <br /> FA0009761 PRO514026 SCO01 07/03/2019 <br /> EHD 22-01 Rev.09/27/2018 Page 5 of 7 Small Quantity Hazardous Waste Generator OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />