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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 /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: FacilityAddress: Date: <br /> Western Dental 320 S CHEROKEE LN, Lodi <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I, CLASS II, or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 110 CCR 66262.42 Failed to comply with uniform hazardous waste manifest exception requirements. <br /> Manifest numbers: <br /> -006693537FLE(was not found on site) <br /> -007686670FLE <br /> -007245286FLE <br /> -007167493FLE <br /> were found without a signed off copy from the destination facility. Hazardous waste generators shall retain copies of <br /> all manifests signed off by the destination facility on site for three years and have them readily available for review. If <br /> the generator did not receive a copy of the manifest with the handwritten signature of the owner or operator of the <br /> facility to which the generator's waste was submitted within 60 days of the date the waste was accepted by the initial <br /> transporter, the generator shall submit a legible copy of the missing manifest,with some indication that the generator <br /> 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. Submit <br /> to the EHD a copy of the signed off copy of the manifest or a copy of the information submitted to DTSC. <br /> This is a Class II violation. <br /> 601 CCR 66262.34(d) Stored hazardous waste onsite greater than 180 days. <br /> A clear 5 gallon container of waste oil inside the waste storage room had a start accumulation date of January 2015. <br /> Facilities who generate less than 1000 kg of hazardous waste per month and do not exceed 6000 kg of waste stored <br /> on site at any time may store waste on site up to 180 days. Immediately contact a licensed hazardous waste hauler to <br /> dispose of this waste under manifest and submit a copy of the manifest to the EHD. <br /> This is a Class II violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by August 14, 2016 . <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials information <br /> online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be sure to include <br /> your hazardous waste activity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> NOTES: <br /> -The facility generates used oil, dental amalgam and flammable liquids containing Ethanol and Formaldehyde <br /> - Provided Return to Compliance Certification <br /> Page 4 of 5 <br />