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SANJ 0 A H I N Environmental Health Department <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> DOLLAR TREE#01263 4555 N PERSHING AVE STOCKTON Aril 11. 2019 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 109 CCR 66262.23(a)(4) Failed to send generator manifest copies to DTSC within 30 days. <br /> According to Courtney Tidwell, store manager,the facility does not send manifest copies to DTSC. <br /> Generator copies of the following manifest numbers were not sent to DTSC within 30 days of shipment of hazardous <br /> waste. <br /> -010740486FLE(8/8/2018)(IMG 5467) <br /> -010740485FLE(8/8/2018)(IMG 5466) <br /> -010740484FLE(8/8/2018)(IMG 5465) <br /> -012121172FLE(10/3/2018)(IMG 5464) <br /> -012121171 FLE(10/3/2018)(IMG 5463) <br /> The generator manifest copy shall be submitted to DTSC for every shipment on a manifest when California is either the <br /> 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 /> FA0007925 PR0538093 SCO01 04/11/2019 <br /> FID 22-01 Rev.09/27/2018 Page 10 of 17 Small Quantity Hazardous Waste Generator OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />