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SAN J O A Q U I N Environmental Health Department <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Smart& Final#593 215 E Lodi Ave, Lodi October 29, 2019 <br /> and address of the location where the facility's waste fluorescent lamps and batteries are taken, the date when <br /> this waste is taken, and the quantity of this waste taken. <br /> An inspection checklist was provided to the facility operator on the day of inspection. The EHD has written the <br /> complete report on 10/30/2019 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, by 11/29/2019. <br /> Provided: Modified Contingency Plan template, Hazardous Waste Labeling Minimum Requirements guidance <br /> sheet, List of Free CUPA Training Classes <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 EHUS CURRENT HOURLY RATE. <br /> Received by: Date: October 30,2019 Inspector: Inspector Phone: <br /> Printed Name and Title: ELIANNA FLORIDO, REHS (209)468-0343 <br /> Emailed to Darryl Dinson, Env. Hlth. Compliance Manager <br /> FA0000698 PR0539384 SCO01 10/29/2019 <br /> EHD 22-01 Rev.9/20/2019 Page 10 of 10 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 />