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S A N J 0 A Q I I I Irl Environmental Health Department <br /> CCUNT <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> Ross Dress For Less#0477 340 W Kettleman Ln, Lodi August 11, 2020 <br /> REGULATION GUIDANCE: All hazardous waste containers shall be marked with the following information: the <br /> words "Hazardous Waste", name and address of generator, hazardous properties, physical state, composition <br /> (contents), accumulation start date <br /> CORRECTIVE ACTION: The violation was corrected during the inspection by Patrick Mueller, the assistant <br /> store manager, who transferred the hand sanitizer into a completely labeled hazardous waste container. No <br /> further action is required to correct this violation. <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 9/10/2020. <br /> To minimize person to person contact EHD is choosing to write the name of person receiving the report instead <br /> of having them sign. Starting September 1, 2018, all in-office CERS help will be provided at EHD hourly rate <br /> ($152). To schedule an appointment, please call (209)468-3420. <br /> Documents provided during inspection: Modified Contingency Plan template, Hazardous Waste Labeling <br /> Requirements guidance sheet, Return to Compliance Certification &Corrective Action Statement form <br /> Waste streams found: shampoos, hand sanitizer, electronics <br /> AFTER THE COMPLIANCE DATE, EHD WILL BILL FOR ALL TIME AND ACTIVITIES ASSOCIATED WITH BRINGING <br /> THIS FACILITY BACK INTO COMPLIANCE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: August 11, 2020 Inspector: Inspector Phone: <br /> Printed Name and Title: ELIANNA FLORIDO, REHS (209)468-0343 <br /> Patrick Mueller,Assistant Store Manager <br /> FA0012563 PR0539585 SCO01 08/11/2020 <br /> EHD 22-01 Rev.9/20/2019 Page 7 of 7 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 />