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SA N J 0 A Q U 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 /> 110 CCR 66262.40(a) Failed to keep signed copy of manifests from the designated facility for three years. <br /> The following manifest numbers were not found at the time of inspection: <br /> -008570570FLE(8/25/2016) <br /> -Page 2 of 008631884FLE(11/25/2016)(IMG 5474) <br /> The following manifest numbers were found without a signed off copy from the destination facility: <br /> -008598921 FLE(7/1/2016)(IMG 5477) <br /> -005888068FLE(4/12/2018)(IMG 5468) <br /> -011386452FLE(5/25/2018)(IMG 5469) <br /> Hazardous waste generators shall retain copies of all manifests for three years or until a copy signed off by the <br /> destination facility is received. The signed off copy shall be retained and made readily available for review for three <br /> years. If the generator did not receive a copy of the manifest with the handwritten signature of the owner or operator of <br /> the facility to which the generator's waste was submitted within 60 days of the date the waste was accepted by the <br /> initial transporter,the generator shall submit a legible copy of the missing manifest,with some indication that the <br /> generator has not received confirmation of delivery. This information shall be submitted to: <br /> DTSC Report Repository <br /> Generator Information Services Section <br /> P.O. Box 806 <br /> Sacramento, CA 95812-0806 <br /> Immediately locate a copy of the missing manifests or prepare and submit the required information to DTSC. <br /> Submit to the EHD a copy of the signed off copy of the manifests or a copy of the information submitted to DTSC. <br /> This is a Class II violation. <br /> FA0007925 PR0538093 SCO01 04/11/2019 <br /> EHD 22-01 Rev.09/27/2018 Page 11 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 />