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SAN J O � � I `II411, Environmental Health Department <br /> C0IJNT`r' <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> BROOKSIDE GOLF&COUNTRY CLUB 3131 BROOKSIDE RD, STOCKTON April 12, 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 110 CCR 66262.40(a) Failed to keep signed copy of manifests from the designated facility for three years. <br /> Copies of uniform manifests for the disposal of hazardous waste for 2016, 2017, 2018, and 2019 were not found on <br /> site for used oil, used coolant, and used oil filters. Hazardous waste generators shall retain copies of all manifests <br /> signed off by the disposal facility and all receipts used in a consolidated manifesting procedure on site for three <br /> years and have them readily available for review. Immediately locate a copy of all manifests and receipts for the last <br /> three years, maintain them on site, and submit copies to the EHD. <br /> This is a repeat violation, Class II. <br /> 113 HSC 25160.2(b)(3) Failed to keep copies of consolidated manifesting receipts for three years. <br /> Copies of hazardous waste disposal records for 2016, 2017, 2018, and 2019 were not found on site for used oil and <br /> used coolant. Hazardous waste generators shall retain copies of all manifests signed off by the disposal facility and <br /> all receipts used in a consolidated manifesting procedure on site for three years and have them readily available for <br /> review. Immediately locate a copy of all manifests and receipts for the last three years, maintain them on site, and <br /> submit copies to the EHD. <br /> This is a repeat violation, Class II. <br /> 114 HSC 25160.2(b)(4)Consolidated manifest receipts failed to contain complete information. <br /> Consolidated manifest receipt invoice number 156164(6/20/2017)from American Valley Waste Oil for the pickup of <br /> used oil was observed missing the name, address, and identification number of the authorized facility to which the <br /> hazardous waste was transported to. <br /> All copies of each receipt shall contain all of the following information: <br /> -The name, address, identification number, contact person, and telephone number of the generator, and the <br /> signature of the generator or the generator's representative; <br /> -The date of the shipment; <br /> -The manifest number; <br /> -The volume or quantity of each waste stream received, its California and RCRA waste codes,the waste stream <br /> type listed in subdivision (c), and its proper shipping description, including the hazardous class and United <br /> Nations/North America(UN/NA)identification number, if applicable; <br /> -The name, address, and identification number of the authorized facility to which the hazardous waste will be <br /> transported; <br /> -The transporter's name, address, and identification number; <br /> -The driver's signature; <br /> -A statement, signed by the generator, certifying that the generator has established a program to reduce the <br /> volume or quantity and toxicity of the hazardous waste to the degree, as determined by the generator,to be <br /> economically practicable. <br /> Ensure that all future receipts for hazardous waste shipments using a consolidated manifesting procedure contain <br /> all required information. <br /> This is a minor violation. <br /> FA0010096 PR0514166 SCO01 04/12/2019 <br /> EHD 22-01 Rev.8/22/2019 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 />