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San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s'gov.org/ehd <br />Small Quantity Hazardous Waste Generator Inspection Report <br />Facility Name: <br />Facility Address: <br />FDaCVS <br />Pharmacy #9949 <br />1201 W MAIN ST, RIPON <br />mber 18, 2018 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />109 <br />CCR 66262.23(a)(4) Failed to send generator manifest copies to DTSC within 30 days. <br />Generator copies of the following manifest numbers were found on site, but are not on file with DTSC: <br />- 011412589FLE (8/13/18) (see photo IMG 1838-1839) <br />- 011412588FLE (8/13/18) (IMG 1840) <br />- 005888209FLE (5/30/18) (IMG 1841) <br />- 005888210FLE (5/30/18) (IMG 1842) <br />- 011386685FLE (3/8/18) (IMG 1843-1844) <br />- 011386684FLE (3/8/18) (IMG 1845-1846) <br />- 008629098FLE (12/23/17) (IMG 1847-1848) <br />- 008629097FLE (12/23/17) (IMG 1849) <br />- 008680147FLE (10/3/17) (IMG 1850-1851) <br />- 008680145FLE (10/3/17) (IMG 1852) <br />- 010168253FLE (7/14/17) (IMG 1853-1854) <br />- 010168050FLE (4/20/17) (IMG 1855) <br />- 008664694FLE (11/10/17) (IMG 1856-1857) <br />The generator manifest copy shall be submitted to DTSC for every shipment on a manifest when California is either <br />the 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 />FA0005664 PR0531037 SCO01 09/18/2018 <br />EHD 22-01 Rev. 09/22/16 Page 5 of 8 Small Quantity Hazardous Waste Generator OIR <br />