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SAN J O A Q U I N Environmental Health Department _COUNTY— Small Quantity Hazardous Waste Generator Inspection Report Facility Name: Facility Address: Date: Dollar General#13357 1 1201 W Main St Ripon August 12 2019 SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 110 CCR 66262.40(a) Failed to keep signed copy of manifests from the designated facility for three years. Manifest number 013120750FLE(6/19/19)was found without a signed off copy from the destination facility. Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three years and have them readily available for review. If the generator did not receive a copy of the manifest with the handwritten signature of the owner or operator of the facility to which the generator's waste was submitted within 60 days of the date the waste was accepted by the initial transporter,the generator shall submit a legible copy of the missing manifest,with some indication that the generator has not received confirmation of delivery. This information shall be submitted to: DTSC Report Repository Generator Information Services Section P.O. Box 806 Sacramento, CA 95812-0806 Immediately locate a copy of the missing manifest or prepare and submit the required information to DTSC. Submit to the EHD a copy of the signed off copy of the manifest or a copy of the information submitted to DTSC. This is a Class II violation. 111 CCR 66262.42(a)(c)(d)Failed to comply with uniform hazardous waste manifest exception requirements. Manifest number 013120750FLE(6/19/19)was found without a signed off copy from the destination facility. Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three years and have them readily available for review. If the generator did not receive a copy of the manifest with the handwritten signature of the owner or operator of the facility to which the generator's waste was submitted within 60 days of the date the waste was accepted by the initial transporter,the generator shall submit a legible copy of the missing manifest,with some indication that the generator has not received confirmation of delivery. This information shall be submitted to: DTSC Report Repository Generator Information Services Section P.O. Box 806 Sacramento, CA 95812-0806 Immediately locate a copy of the missing manifest or prepare and submit the required information to DTSC. Submit to the EHD a copy of the signed off copy of the manifest or a copy of the information submitted to DTSC. This is a Class II violation. FA0000662 PRO537832 SCO01 08/12/2019 EHD 22-01 Rev.09/27/2018 Page 10 of 13 Small Quantity Hazardous Waste Generator OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com