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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s'gov.org/ehd CONTINUATION FORM Page: 5 of 5 OFFICIAL INSPECTIONREPORT Date: 06/21/12 Facility Address: 7850 R A Bridgeford, Stockton Program: HW SUMMARY OF VIOLATIONS CLASS I, CLASS II, or MINOR -Notice to Comply) Minor Notice to comply 121. Manifest numbers 000039115DAT, 000037812DAT, 000037810DAT, 000020654DAT, 000020830DAT, 000020655DAT, 000021157DAT, 000021156DAT, 000037597DAT, 000018135DAT, 000018169DAT, 00002992175FLE, 002043393FLE, 000036073DAT, 000038237DAT, 000038238DAT, 000038463DAT, 000038040DAT, 000039265DAT, 000020837DAT and 000039114DAT was not sent to the DTSC by the generator. Manifest shall be submitted to the department by any generator when the waste is generated in California of is transported to a designated facility located in California. The generator manifest shall be submitted to the department for every shipment on a manifest when California is either the generator state or the destination or consignment state. The generator manifest copy shall be mail to: DTSC Generator Manifest P.O. Box 400 Sacramento, CA 95812-0400 Provide proof of corrective action to the EHD within 30 days of receiving this report. Notes Complete and submit a copy of the Return to Compliance Certification form with a statement of how each violation was corrected, including supporting documentation, to the EHD within 30 days of receiving this report. ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. EHD Inspector. Rece ved By: Title: Muniappa Naidu (209) 468-3439 A EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM