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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue,6tooktgn,California 95206-6232 <br /> TBfephone:(209)488-3420.Fax:(208)468-3433 Web.NWww sigoy,oro/ehd <br /> Small Q an�tity Hazardous*Waste Generator Inspection Repo <br /> Facility Name: Facility Address; bate; <br /> Varixon Business: KINGCA 13860 N DE VRIES RD LODI §eptember 03 2015 <br /> SUMMARY OF VIOLATIONS <br /> jC*SS 1,CLASS it;ul MIND <br /> Itani#i Rem rke <br /> 11 CCR 60262,40(a)Failed to keep signed copy of.manifests from the designated faculty for three years. <br /> Manifest numbers 00 555746FLE and 006655495FLE were not found on site. Hazardous waste generators shall <br /> retain copies of all mE nlfests for three years or until a copy signed off by the destination facility Is received. The <br /> signed off copy shall I ie retained and made readily available for review for three years. If the generator did not receive a <br /> copy of the Manifest v 6th the handwritten signature of the owner or operator of the facility to which the generator's <br /> waste was submitted Mthin 60 days of the date the waste was accepted by the initial transporter, the generator shall <br /> submit a legible copy of the missing manifest,with some indication that the generator has not received confirmation of <br /> 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 manifests or a copy of the information submitted to pTSC. <br /> This Is a repeat violation, Class II. <br /> Overall Inspecdon Comments: <br /> On site to conduct a routine hazardous waste Inspection. <br /> Complete and submit a gopy 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 10-3-15. <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:ltcers.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. '. -n <br /> -. ,� <br /> SEP 17 2015 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> ALL EHD STAFF TIME ASSOCKED MM MUNZI TO COMPLY BY THIE ABOVE NOTED BATES WLL 13E NUEDAT THE CURREN r HOUMY WE <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE, <br /> Received By Received By(printed name and title): Data, <br /> (signature): Jonathan Pakele,Verizon Associate <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): ARTS VELOSO, Senior RENS (209)468-3463 <br /> Page 4 of 4 <br />