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S0 JOA U 1 Environmental Health Department <br /> u ; i y <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Ross Dress For Less#0035 5756 PACIFIC AVE, STOCKTON JUly 31, 2020 <br /> Overall Inspection Comments: <br /> An inspection checklist was provided to the facility operator on the day of inspection. A complete report was <br /> finished on 8/5/2020 and 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 9/4/2020. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during/after inspection: List of Free CUPA Training Classes, Modified Contingency Plan <br /> template, Return to Compliance Certification (RTC) & Corrective Action Statement(CAS)form, inspection <br /> photos <br /> Waste streams found: perfumes/fragrances, leather cleaner, cosmetics, aerosol can, ink tags, soaps, <br /> electronics <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 EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: August 05, 2020 Inspector: Inspector Phone: <br /> Printed Name and Title: ELIANNA FLORIDO, REHS (209)468-0343 <br /> Melody Engaling,Assistant Store Manager <br /> FA0002178 PR0539592 SCO01 07/31/2020 <br /> EHD 22-01 Rev.9/20/2019 Page 8 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 />