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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.sogov.org/ehd <br />RCRA Large Quantity Hazardous Waste Generator Inspection Report <br />Facility Name: <br />Facility Address: <br />Date: <br />CVS PHARMACY #16223 <br />2800 NAGLEE RD, Tracy <br />January 28, 2019 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />113 <br />CCR 66262.23(a) Failed to complete, sign or date manifest; or obtain dated signature of transporter. <br />The following manifests were found on site and do not appear to include the weight of the empty warfarin containers <br />in the total amount of hazardous waste generated: <br />- 012121066FLE (9/13/18) (IMG 3870) <br />- 008629030FLE (1/9/18) (IMG 3866) <br />- 009149341 FLE (10/19/17) <br />- 010169383FLE (7/26/17) (IMG 3869) <br />- 010169098FLE (5/3/17) <br />- 008597861 FLE (2/7/17) (IMG 3868) <br />- 008597594FLE (11/19/16) <br />- 008572177FLE (9/6/16) <br />- 008598853FLE (6/16/16) <br />The generator and waste sections of the uniform manifest shall be completed and signed and dated by the <br />generator. The transporter shall also sign and date the manifest. <br />Ensure that all manifests are properly completed for any transport of a hazardous waste for off-site transfer, <br />treatment, storage or disposal. <br />This is a Class II violation. <br />114 <br />CCR 66262.23(a)(4) Failed to send generator manifest copies to DTSC within 30 days. <br />Generator copies of the following manifests numbers were found on site, but are not on filed with DTSC: <br />- 012497617FLE (12/7/18) (IMG 3871) <br />- 012121065FLE (9/13/18) (IMG 3862) <br />- 012121066FLE (9/13/18) (IMG 3870) <br />- 011387316FLE (6/20/18) (IMG 3863) <br />- 010169383FLE (7/26/17) (IMG 3869) <br />- 008597861 FLE (2/7/17) (IMG 3868) <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 />FA0023489 PR0541027 SCO01 01/28/2019 <br />EHD 22-03 Rev. 09/22/16 Page 5 of 10 RCRA Large Quantity Hazardous Waste Generator OIR <br />