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SAN.JOAQU1N <br />COUNTY <br />Environmental Health Department <br />AMENDED <br />11/25/2019 <br />Small Quantity Hazardous Waste Generator Inspection Report <br />Facility Name: <br />GOLDEN STATE LUMBER INC <br />Facility Address: <br />3033 S Airport Way. Stockton <br />Date: <br />November 22. 2019 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # Remarks <br />114 HSC 25160.2(b)(4) Consolidated manifest receipts failed to contain complete information. <br />OBSERVATION: Consolidated manifest receipts found on-site for disposal of hazardous waste picked up by <br />Maximum Oil Service contained incomplete information. <br />-Invoice 46893, 1/20/2019, for the pickup of used oil, was missing information on where the waste was taken. <br />-Invoice 50992, 10/3/2019, for the pickup of used oil, was missing information on where the waste was taken. <br />-Invoice 49880, 7/30/2019, for the pickup of used oil, was missing information on where the waste was taken. <br />-Invoice 49317, 5/15/2019, for the pickup of used oil, was missing information on where the waste was taken. <br />-Invoice 45577, 1/23/2018, for the pickup of used oil and used antifreeze, was missing information on where the <br />waste was taken. <br />-Invoice 45998, 4/9/2018, for the pickup of used oil, was missing information on where the waste was taken. <br />-Invoice 46085, 6/19/2019, for the pickup of used oil, was missing information on where the waste was taken and <br />the generator signature. <br />-Invoice 46803, 7/25/2018, for the pickup of used oil, was missing information on where the waste was taken. <br />Invoice 47801, 10/9/2018, for the pickup of used oil and used antifreeze, was missing information on where the <br />waste was taken. <br />Invoice 47930, 11/21/2018, for the pickup of used oil, was missing information on where the waste was taken and <br />the generator signature. <br />REGULATION GUIDANCE: (4) All copies of each receipt shall contain all of the following information: <br />The name, address, identification number, contact person, and telephone number of the generator, and the <br />signature of the generator or the generator's representative. <br />The date of the shipment. <br />The manifest number. <br />The volume or quantity of each waste stream received, its California and RCRA waste codes, the wastestream <br />type listed in subdivision (c), and its proper shipping description, including the hazardous class and United <br />Nations/North America (UN/NA) identification number, if applicable. <br />The name, address, and identification number of the authorized facility to which the hazardous waste will be <br />transported. <br />The transporter's name, address, and identification number. <br />The driver's signature. <br />A statement, signed by the generator, certifying that the generator has established a program to reduce the <br />volume or quantity and toxicity of the hazardous waste to the degree, as determined by the generator, to be <br />economically practicable. <br />CORRECTIVE ACTION: Provide a corrective action statement and supporting documentation to the San Joaquin <br />County Environmental Health Department within 30 days. <br />This is a Class II violation. <br />FA0015541 PR0538493 SC001 11/22/2019 <br />EHD 22-01 Rev. 9/20/2019 <br />Page 10 of 16 <br /> Small Quantity Hazardous Waste Generator OIR <br />1868 E. HazeIton Avenue I Stockton, California 952051 T 209 468-3420 I F 209 464-0138 I www.sjcehd.com