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SA N sJ V AH I • ,N Environmental Health Department <br /> COIL) NTY <br /> Large Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name : Facility Address : Date : <br /> Universal Waste r <br /> 716 CCR 66273. 40(a)(3) (4) UW handler sending devices/CRTs/CRT glass to foreign destination failed to submit notification ❑ V ❑ R ❑ COS <br /> 717 CCR 66273. 32(b) UWH failed to obtain an ID number from DTSC prior to accumulating >5000kg of non-RCRA UW ❑ V ❑ R ❑ COS <br /> 718 CCR 66273. 32(d) Failure of a UW handler to submit a complete annual report to DTSC ❑ V ❑ R ❑ COS <br /> 719 CCR 66273. 38 Failure of UW handler to transfer UW to the appropriate destination facility ❑ V ❑ R ❑ COS <br /> 720 CCR 66273 , 31 (a) UW handler caused improper disposal of UW ❑ V ❑ R ❑ COS <br /> 721 CCR 66273. 8(b) Conditionally exempt small quantity UW generator caused improper disposal of UW ❑ V ❑ R ❑ COS <br /> Appliance Recycler <br /> 801 HSC 25211 .4 Failure to obtain Certified Appliance Recycler certification (CAR) ❑ V ❑ R ❑ COS <br /> 802 HSC 25211 . 2, 25211 .3 Failure of a CAR to provide docs that materials that require special handling have been removed ❑ V ❑ R ❑ COS <br /> 803 HSC 25212 Failure of a CAR to properly remove and dispose of all materials that require special handling ❑ V ❑ R ❑ COS <br /> Other Violations <br /> 3010 See below Unlisted Administration/Documentation violation ❑ V ❑ R ❑ COS <br /> 3020 See below Unlisted Training violation ❑ V ❑ R ❑ COS <br /> 3030 See below Unlisted Operations/Maintenance violation ❑ V ❑ R ❑ COS <br /> 3040 See below Unlisted Release/Leaks/Spills violation ❑ V ❑ R ❑ COS <br /> 3050 See below Unlisted Abandonment/Illegal Disposal/Unauthorized Treatment violation ❑ V ❑ R ❑ COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I, CLASS II, or MINOR - Notice to Comply) <br /> Item # Remarks <br /> Overall Inspection Comments . <br /> o -r I tJ ,A CA 0 L) .s vvLA S�- +e< b o n� E 't o A y AT <br /> C L oto S4E ; c �} / 120 1_. Cc r , C WS G K. Lt 5T v/ AS � rz:::; <br /> V, L4 L L jZ p o 12--t' vJ 1 LA- V i e 1 L <br /> AND � N G � L� V l LL, A 11 0 <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 EHD'S CURRENT HOURLY RATE . <br /> Received by : Date: D/ �f / 9 Inspector: + Inspector_ Phone: <br /> Printed Name and Title : <br /> FA0002064 PR0518490 SCO03 06/12/2019 <br /> EHD 22-02 Rev. 09/27/2018 Page 4 of 4 Large 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 />