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SAN JOAQU I N <br />CC) U,IN I Y <br />Environmental Health Department <br />AMENDED <br />1/2/2020 <br />Large Quantity Hazardous Waste Generator Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />JIFFY LUBE #2322 <br />500 E KETTLEMAN LN, LODI <br />December 12, 2019 <br />Overall Inspection Comments: <br />An inspection checklist was provided to the facility operator on the day of inspection. The EHD has written the <br />complete report on January 02, 2020 which replaces the initial checklist. <br />Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br />documenting the corrective actions that have been or will be taken for each violation, and any supporting <br />paperwork, within 30 days of receiving the complete inspection report. <br />Waste streams found: used oil, used antifreeze, oily solids, oily water, used paper oil filters, used metal oil <br />filters, used lead acid batteries, used shop towels, used mop heads <br />Documents Provided: Contingency Plan template, Return to Compliance Certification form, Corrective Action <br />Statement form, Schedule of Free CUPA classes, Employee Training template, and Hazardous Waste Labeling <br />information <br />AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br />THIS FACILITY BACK INTO COMPLIANCE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received by: Date: January 02, 2020 <br />Inspector: <br />Inspector Phone: <br />Printed Name and Title: <br />CLAUDIA MURO, EH Specialist <br />(209) 468-3429 <br />Brandon Pitz, Store Manager <br />FA0010973 PR0514476 SCO01 12/12/2019 <br />EHD 22-02 Rev. 9/20/2019 Page 8 of 8 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 />