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A J OA U I Environmental Health Department <br /> COUNTY <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> STOCKTON MOBIL#1 642 N HUNTER ST, STOCKTON May 03, 2021 <br /> Other Violations <br /> 3050 1 See below Unlisted Abandonment/Illegal Disposal/Unauthorized Treatment violation ❑V ❑R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 107 CCR 66262.20 Failed to prepare manifests for transportation of hazardous waste. <br /> OBSERVATION: Fuel contaminated water was transported off site without first preparing an Uniform Hazardous <br /> Waste Manifest. <br /> REGULATION GUIDANCE: A hazardous waste generator who transports, or offers for transport a hazardous <br /> waste for off-site transfer, treatment, storage, or disposal shall prepare a Uniform Hazardous Waste Manifest (OMB <br /> Control number 2050-0039)on EPA Form 8700-22, and, if necessary, a Continuation Sheet on EPA Form 8700- <br /> 22A, according to the instructions included in the Appendix to chapter 12 of this division before the waste is <br /> transported off-site. <br /> CORRECTIVE ACTION: When required by California Health & Safety Code and Title 22 California Code of <br /> Regulations, ensure that an Uniform Hazardous Waste Manifest is prepared each time to transport hazardous <br /> waste from this facility for off-site transfer, treatment, storage or disposal. Provide a corrective action statement and <br /> any supporting documentation to the San Joaquin County Environmental Health Department(EHD)within 30 days. <br /> This is a Class II violation. <br /> Overall Inspection Comments: <br /> An inspection checklist was provided to the facility operator on the day of inspection. A complete report was <br /> finished on 5/18/21 and replaces the initial checklist. <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, within 30 days of receiving the complete inspection report. <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: May 03, 2021 Inspector: Inspector Phone: <br /> Printed Name and Title: FREDERICK ERNEST, EHS Trainee (209) 616-3026 <br /> Email sent to; Malek Nasher, Manager <br /> FA0000799 PR0526834 SCO01 05/03/2021 <br /> EHD 22-01 Rev.9/16/2020 Page 4 of 4 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.sjgov.org/EHD <br />