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SA N J o /Ai 4 U I I W Environmental Health Department <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Dollar Tree#05531 2400 McHenry Ave Escalon Mav 24, 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 109 CCR 66262.23(a)(4) Failed to send generator manifest copies to DTSC within 30 days. <br /> According to Adrienne Church, Store Manager, manifests received by the facility for the disposal of hazardous waste <br /> are kept in a file folder in the facility office, and copies of the manifests are not sent or mailed anywhere. <br /> Copies of the following manifests numbers were observed on site, but are not on file with DTSC: <br /> -005888289FLE(6/20/18)(IMG 6659) <br /> -011385071 FLE(9/17/18) <br /> -011385072FLE(9/17/18) <br /> -011385980FLE(1/18/19) <br /> -011385979FLE(1/18/19) <br /> -013120558FLE(5/8/19)(IMG 6656) <br /> -013120559FLE(5/8/19)(IMG 6657) <br /> -013120560FLE(5/8/19)(IMG 6658) <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 /> FA0022370 PRO539306 SCO01 05/24/2019 <br /> EHD 22-01 Rev.09/27/2018 Page 8 of 12 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 />