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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.sigov.org/ehd <br /> RCRA Large Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> CVS PHARMACY#17412 1 16858 GOLDEN VALLEY PKWY, Lathrop January 30, 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 114 CCR 66262.23(a)(4)Failed to send generator manifest copies to DTSC within 30 days. <br /> The following manifest numbers were found on site, but are not on file with DTSC: <br /> -011392812FLE (11/8/18)(IMG 3996) <br /> -011392813FLE (11/8/18)(IMG 4006) <br /> -011434310FLE (8/15/18)(IMG 4009) <br /> -011434309FLE (8/15/18)(IMG 4008) <br /> -011387268FLE (5/30/18)(IMG 4007) <br /> -008597532FLE (11/4/16)(IMG 4005) <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 /> FA0023485 PR0541023 SCO01 01/30/2019 <br /> EHD 22-03 Rev.09/22/16 Page 5 of 10 RCRA Large Quantity Hazardous Waste Generator OIR <br />