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SAN JOAQUIN COUNTY V <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 /> CONTINUATION FORM Page: 8 of 8 <br /> OFFICIAL INSPECTION REPORT Date: 10/29/13 <br /> Facility Address: 4232 E. Main St., Stockton Program: HW <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II, or MINOR-Notice to Comply) <br /> Violation #812-Failed to keep records of each shipment of universal waste. <br /> Copies of universal waste disposal records were not found on site. <br /> A generator of universal waste (batteries, mercury containing equipment, lamps/bulbs, electronic <br /> devices, CRTs, CRT glass, aerosol cans) shall keep a record of each shipment of universal waste on <br /> site for at least three years. The record may take the form of a log, invoice, manifest, bill of lading, or <br /> other shipping document, and shall include the following: <br /> - Name & address of destination facility <br /> - Quantity & type of universal waste <br /> - Date of departure/shipment <br /> Begin this practice immediately. <br /> Complete and submit a copy of the Return to Compliance Certification to the EHD by December 6, 2013, <br /> along with a statement documenting the corrective actions that have been or will be taken for each <br /> violation and any supporting paperwork. <br /> Provided: <br /> - Modified Contingency Plan template <br /> - Schedule of FREE classes <br /> - Return to Compliance Certification form <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINS PECTIY TIK AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Reive Title: <br /> Stacy Rivera (209) 468-3440 <br /> EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />