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SANSâ–ş MUIN <br />COUNTY <br />Environmental Health Department <br />AM"FM <br />8/20/2019 <br />Small Quantity Hazardous Waste Generator Inspection Report <br />Facility Name: <br />Facility Address: <br />1 <br />Date: <br />Dollar General #14661 <br />1940 McHenry Ave. Escalon <br />August 14 2019 <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR - Notice to Comply) <br />Item # <br />Remarks <br />110 <br />CCR 66262.40(a) Failed to keep signed copy of manifests from the designated facility for three years. <br />Manifest number 011386809FLE (1/29/18) (IMG 8332) was found without a signed off copy from the destination facility. <br />Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three <br />years and have them readily available for review. If the generator did not receive a copy of the manifest with the <br />handwritten signature of the owner or operator of the facility to which the generator's waste was submitted within 60 <br />days of the date the waste was accepted by the initial transporter, the generator shall submit a legible copy of the <br />missing manifest, with some indication that the generator has not received confirmation of delivery. This information <br />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 manifest or prepare and submit the required information to DTSC. <br />Submit 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 />111 <br />CCR 66262.42(a)(c)(d) Failed to comply with uniform hazardous waste manifest exception requirements. <br />Manifest number 011386809FLE (1/29/18) (IMG 8332) was found without a signed off copy from the destination facility. <br />Hazardous waste generators shall retain copies of all manifests signed off by the destination facility on site for three <br />years and have them readily available for review. If the generator did not receive a copy of the manifest with the <br />handwritten signature of the owner or operator of the facility to which the generator's waste was submitted within 60 <br />days of the date the waste was accepted by the initial transporter, the generator shall submit a legible copy of the <br />missing manifest, with some indication that the generator has not received confirmation of delivery. This information <br />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 manifest or prepare and submit the required information to DTSC. <br />Submit 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 />Overall Inspection Comments: <br />Notes: <br />- The inspection report was amended by adding Violation 103. <br />FA0022207 PRO540012 SCO01 08/14/2019 <br />EHD 22-01 Rev. 09/27/2018 Page 8 of 9 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 />