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S jAN J O ` �UJ Environmental Health Department <br /> C TY <br /> Small uantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> VALERO#3698 153 E ELEVENTH ST, TRACY January 24, 2018 <br /> Complete and submit a copy of heReturn to Compliance Certification form to the EHD with a statement <br /> documenting the corrective acti ns that have been or will be taken for each violation, and any supporting <br /> paperwork, by February 23, 201 . <br /> Documents reviewed by regulat r: Disposal records, training record, and modified contingency plan. <br /> Documents received b�operato : Modified contingency plan, hazardous waste label sample, routine inspection <br /> report, and return to co pliance certification form. <br /> Note: Generator copy f manife t number 003434508GBF was not sent to DTSC within 30 days of shipment of <br /> hazardous waste. The generat manifest copy shall be submitted to DTSC for every shipment on a manifest <br /> when California is eith the gen rator state or the destination or consignment state. The generator manifest <br /> copy shall be mailed to, <br /> DTSC Generator Manifests <br /> P.O. Box 400 <br /> Sacramento, CA 95812-040 <br /> Immediately mail a copy of the IT anifests listed and ensure that copies of all generator manifests are sent to <br /> DTSC within 30 days of shipping hazardous waste. The facility owner provided a statement that he will start <br /> documenting the manif sts that I ie sends to DTSC.A statement was provided during the inspection. This was <br /> corrected on site. <br /> Note: An emergency coordinator and modified contingency plan information is lacking. There must be at least <br /> one emergency coordinator on s e or on call to coordinate emergency response measures, and the following <br /> information must be posted by a hone: the name and phone number of the emergency coordinator; location of <br /> fire extinguishers, spill Ontrol eq ipment, and if present, fire alarm: and the phone number of the fire <br /> department, unless the acility h s a direct alarm. Immediately appoint an emergency coordinator and post the <br /> required information by phone. A form is provided that can be used for this purpose. Facility owner completed <br /> a modified contingency Ian and placed in the store front near a telephone during the inspection. This was <br /> corrected on site. <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FAIJILITY IS E UBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: 124/18 Inspector: Inspector Phone: <br /> ' P ted Name and Tittle: BETTY HO, EH Specialist (209)468-3455 <br /> ��h ��� S <br /> FA0003709 PRO518465 SCO01 01/24/2018 <br /> EHD 22-01 Rev.10/31/2017 Page 4 of 4 Small Quantity Hazardous Waste Generator OIR <br /> 1868 E. Hazelton Aven e I Stockton. California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />