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SANJ O AN N Environmental Health Department <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: <br /> T�acility Address: Date: <br /> Dollar General#13592 310 W Charter Way, Stockton ]July 24, 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 108 CCR 66262.23(a) Failed to complete, sign or date manifest; or obtain dated signature of transporter. <br /> The 2018 and 2019 uniform hazardous waste manifests are being completed using generator EPA ID number <br /> CAR000278318. However,this facility's EPA ID numbers are CAR000278317 and CAL000373076. (IMG 7678-82, <br /> 7684-93) <br /> (Note: It is recommended for the facility to have only one active EPA ID number.) <br /> The generator and waste sections of the uniform manifest shall be completed and signed and dated by the generator. <br /> The transporter shall also sign and date the manifest. <br /> Ensure that all manifests are properly completed for any transport of a hazardous waste for off-site transfer,treatment, <br /> storage or disposal. <br /> This is a Class II violation. <br /> 109 CCR 66262.23(a)(4) Failed to send generator manifest copies to DTSC within 30 days. <br /> According to Jeffrey Delgado,Assistant Store Manager manifests received by the facility for the disposal of hazardous <br /> waste are kept in a binder in the hazardous waste storage area, and copies of the manifests are not sent or mailed <br /> anywhere. <br /> Copies of the following manifests numbers were observed on site, but are not on file with DTSC: <br /> -013120860FLE(7/8/19)(IMG 7678) <br /> -013120861 FLE(7/8/19)(IMG 7679) <br /> -012962957FLE(4/10/19)(IMG 7680) <br /> -012497983FLE(1/31/19)(IMG 7681) <br /> -011392832FLE(11/7/18)(IMG 7682) <br /> -011434267FLE(8/8/18)(IMG 7684-5) <br /> -011434268FLE(8/8/18)(IMG 7686) <br /> -005888174FLE(5/16/18)(IMG 7687) <br /> -005888175FLE(5/16/18) <br /> -011387034FLE(3/15/18)(IMG 7688) <br /> -010791246FLE(12/22/17)(IMG 7690) <br /> -008664884FLE(9/22/16)(IMG 7699) <br /> The generator manifest copy shall be submitted to DTSC for every shipment on a manifest when California is either the <br /> generator state or the destination or consignment state. The generator manifest copy shall be mailed to: <br /> DTSC Generator Manifests <br /> P.O. Box 400 <br /> Sacramento, CA 95812-0400 <br /> Immediately mail a copy of the manifests listed and ensure that copies of all generator manifests are sent to DTSC <br /> within 30 days of shipping hazardous waste. <br /> This is a Class II violation. <br /> FA0002150 PR0537571 SC001 07/24/2019 <br /> EHD 22-01 Rev.09/27/2018 Page 5 of 8 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 />