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r � SAN 10 A Q U I N Environmental Health Department AWtv. COUNTY cu a Greatness grows Mere Small Quantity Hazardous Waste Generator Inspection Report Facility Name: Facility Phone: Date: DaVita Port City Dialysis (209)946-0738 October 30, 2019 Facility Address: CERS ID: 1810 S Fresno Ave, Stockton, CA 95206 10748380 Inspection Contact: Title: Phone: Narey Khun Facility Administrator 1 (209)946-0738 Inspection Type: Program: ROUTINE INSPECTION-Operating Permit 12220-SM HW GEN<5 TONSNR Consent For: Consent Given By: ❑x Inspection ❑x Photos ❑ Samples Narey Khun, Facility Administrator Amount of hazardous waste generated EPA/State ID: in the last calendar year(Jan-Dec): 0.00 tons CCR=Title 22 California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection Record Keeping/Documentation 101 CCR 66262.12 Managed a hazardous waste without an identification number D V D R D COS 102 CCR 66262.11 Failed to determine if a waste is a hazardous waste D V D R D COS 103 CCR 66262.40(c) Failed to retain hazardous waste determination including waste analysis on site for 3 years D V D R D COS 104 CCR 66262.34(d)(2) No modified contingency plan D V D R D COS 105 CCR 66262.34(d)(2) No emergency coordinator D V D R D COS 106 CCR 66262.34(d)(2) Failed to Vain employees on waste handling and emergency procedures D V D R D COS 107 CCR 66262.20 Failed to prepare manifests for transportation of hazardous waste D V D R D COS 108 CCR 66262.23(a) Failed to complete,sign or date manifest;or obtain dated signature of transporter D V D R D COS 109 CCR 66262.23(a)(4) Failed to send generator manifest copies to DTSC within 30 days D V D R D COS 110 CCR 66262.40(a) Failed to keep signed copy of manifests from the designated facility for three years D V D R D COS 111 CCR 66262.42(a)(c)(d) Failed to comply with uniform hazardous waste manifest exception requirements D V D R D COS 112 CCR 66268.7(a) Failed to make determination for land disposal D V D R D COS 113 HSC 25160.2(b)(3) Failed to keep copies of consolidated manifesting receipts for three years D V D R D COS 114 HSC 25160.2(b)(4) Consolidated manifest receipts failed to contain complete information D V D R D COS 115 CCR 66266.81(a)(4)(B) Failed to retain copy of manifest or bill of lading for spent lead acid batteries for 3 years D V OR D COS 116 HSC 25143.10 Failed to provide information for>100 kg/mo recyclable material to claim the exclusion or exemption D V D R D COS 117 HSC 25185(c)(3) Failed to submit a written response within 30 days of receiving an inspection report DV D R D COS 118 HSC 25110.10(d) Failure to annually submit notification of generator intent to remotely consolidate hazardous waste D V D R D COS 119 HSC 25404(e)(4) Failed to report program data in the California Environmental Reporting System(CERS) D V D R D COS 120 HSC 25404.1.2 Failed to submit a certification and written response within 30 days for minor violations DV D R n COS Treatment,Transport and Disposal 201 HSC 25163(a) Transported or transferred hazardous waste to a transporter without valid registration D V D R D COS 202 HSC 25189.5(a) Disposed or caused disposal of HW at an unauthorized point D V D R D COS 203 HSC 25189.5(c) Transported or caused transportation of hazardous waste to an unauthorized point D V D R D COS 204 HSC 25201(a) Failed to obtain a permit to treat hazardous waste D V D R D COS 205 HSC 25250.7 Failed to prevent intentional contamination of used oil with other hazardous waste D V D R D COS 206 HSC 25160.2(c)(2) Waste stream or generator not eligible to use consolidated manifesting procedure D V D R o COS FA0024306 PRO542557 SCO01 10/30/2019 EHD 22-01 Rev.9/20/2019 Page 1 of 4 Small Quantity Hazardous Waste Generator OIR 1868 E. Hazelton Avenue I Stockton, California 95205 IT 209 468-3420 1 F 209464-0138 1 www.sjcehd.com