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S0 JOA U 1 Environmental Health Department U ; i y Small Quantity Hazardous Waste Generator Inspection Report Facility Name: Facility Address: Date: S-Mart#91 1 7506 Pacific Ave, Stockton October 26, 2020 SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 108 CCR 66262.23(a) Failed to complete, sign or date manifest; or obtain dated signature of transporter. OBSERVATION: Uniform Hazardous Waste Manifests from 2017 through 2020 state"gen. status determination excludes container wt."for the 1 pound of warfarin"waste residue last contained," indicating that the weight of the contaminated warfarin containers are not being counted toward the total amount of hazardous waste generated on each manifest. According to a Department of Toxic Substances Control (DTSC)letter dated 8/2/2018, DTSC confirms that "California healthcare facilities(hazardous waste generators)must include the weight of the[warfarin] container and residue when completing a Uniform Hazardous Waste Manifest. The combined weight counts toward the generator status." REGULATION GUIDANCE: (a)The generator of any hazardous or extremely hazardous waste to be transported off-site or into California shall: (1)complete the generator and waste section and sign the manifest certification according to the instructions in the Appendix to this chapter; and (2)obtain the handwritten signature of the initial transporter and date of acceptance on the manifest; and (3)retain one copy, in accordance with section 66262.40(a); and (4)within 30 days of each shipment of hazardous waste submit to the Department a legible copy of each manifest used; and (5)on or after September 5, 2006,for hazardous waste that is not regulated as a hazardous waste by the U.S. EPA (non-RCRA waste),describe these wastes in Item 9b of the manifest or Item 27b of the continuation sheet as follows: (A)describe non-RCRA hazardous wastes which do not have a U.S. DOT description indicating a generic name of the waste and the phrase"Non-RCRA Hazardous Waste, Solid"or"Non-RCRA Hazardous Waste, Liquid"for solid or liquid wastes, respectively. When possible,the generic name shall be obtained from chapter 11,Appendix X, subsection (b)of this division. If not listed in chapter 11,Appendix X, subsection (b)of this division, the commonly recognized industrial name of the waste shall be used. (B)describe non-RCRA hazardous wastes which have a U.S. DOT description by the U.S. DOT description, and (6)The EPA hazardous waste number, if applicable, can be found in chapter 11, articles 3 and 4 and the California Hazardous Waste Code Number can be found in chapter 11,Appendix XII. CORRECTIVE ACTION: Immediately begin counting the weight of the contaminated warfarin containers toward the facility's total amount of hazardous waste generated on each manifest.A manifest correction letter must be sent to the Department of Toxic Substances Control (DTSC)whenever hazardous waste manifests submissions contain incorrect or incomplete information. Submit a letter by providing the manifest corrections on company letterhead, and include the following information: the manifest tracking number(nine numbers followed by three letters);the generator date;the date the generator signed the manifest;the generator EPA ID number used on the original manifest, even if it was incorrect;the incorrect or incomplete item number(s)from the manifest; the corrected information and the signature,title, mailing address, and phone number of the person submitting the correction. Send manifest correction letters to: DTSC Business Operations Unit,Attention: Manifest Corrections, P.O. Box 806, Sacramento, CA 95812-0806. Also provide a corrective action statement and a copy of correction letter to the San Joaquin County Environmental Health Department within 30 days. This is a Class II violation. FA0002617 PR0539363 SCO01 10/26/2020 EHD 22-01 Rev.9/16/2020 Page 5 of 8 Small Quantity Hazardous Waste Generator OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD