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SANA ` , 1 0 A � � I ` , Environmental Health Department <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Big Lots Tracy 4457 2681 N Tracy Blvd, Tracy June 25. 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 /> The following manifest was not found on site: <br /> -000202177DAT(1/10/18) <br /> The following manifests numbers were found without a signed off copy from the destination facility: <br /> -002301853PSC(4/29/19)(IMG 7108) <br /> -002107642PSC(2/4/19)(IMG 7111) <br /> -002107641 PSC(2/4/19)(IMG 7109-10) <br /> -002005767PSC (11/12/18)(IMG 7113) <br /> -001986545PSC(10/1/18)(IMG 7114) <br /> -001968846PSC(9/17/18)(IMG 7115) <br /> -001938562PSC(8/20/18)(IMG 7116) <br /> -001918410PSC(7/23/18)(IMG 7117) <br /> -000212418DAT(4/11/18)(IMG 7119-20) <br /> -001874357PSC(5/29/18)(IMG 7118) <br /> -00179396OPSC(3/13/18)(IMG 7121) <br /> -000183705DAT(8/21/17)(IMG 7122-3) <br /> Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three <br /> years and have them readily available for review. If the generator did not receive a copy of the manifest with the <br /> handwritten signature of the owner or operator of the facility to which the generator's waste was submitted within 60 <br /> days of the date the waste was accepted by the initial transporter,the generator shall submit a legible copy of the <br /> missing manifest,with some indication that the generator has not received confirmation of delivery. This information <br /> shall be submitted to: <br /> DTSC Report Repository <br /> Generator Information Services Section <br /> P.O. Box 806 <br /> Sacramento, CA 95812-0806 <br /> Immediately locate a copy of the missing manifests or prepare and submit the required information to DTSC. <br /> Submit to the EHD a copy of the signed off copy of the manifests or a copy of the information submitted to DTSC. <br /> This is a repeat violation, Class II. <br /> FA0003106 PRO538909 SCO01 06/25/2019 <br /> EHD 22-01 Rev.09/27/2018 Page 7 of 11 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 />