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SAN 10 A Q U I N Environmental Health Department <br /> AMENDED <br /> 11/15/2023 <br /> Small Quantity Hazardous Waste Generator Inspection Report <br /> Facility Name: Facility Address: Date: <br /> MANTECA DENTAL CARE 1007 S MAIN ST, MANTECA September 27,2023 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 715 CCR 66273.39 Universal Waste Handler failed to keep three years records of each shipment of universal waste. <br /> OBSERVATION: Copies of universal waste(UW)disposal records for mercury containing filters were not found on <br /> site. <br /> REGULATION GUIDANCE:Title 22 California Code of Regulations section 66273.39.Tracking Universal Waste <br /> Shipments <br /> (c)Shipments offsite.A universal waste handler shall keep a record of each shipment of universal waste sent from <br /> the universal waste handler's facility to another facility.The record may take the form of a log,invoice,manifest,bill <br /> of lading,movement document,or other shipping document.The record for each shipment of universal waste sent <br /> shall include the following information: <br /> (1)The name and address of the universal waste handler or destination facility to which the universal waste was <br /> sent; <br /> (2)The quantity[count or weight,consistent with,for example,section 66273.32,subsection(d)]of each type of <br /> universal waste sent(e.g.,batteries,thermostats,lamps,electronic devices,CRTs,CRT glass,PV modules);and <br /> (3)The date of departure of the shipment of universal waste. <br /> CORRECTIVE ACTION: Immediately locate a copy of all UW disposal records for the last three years and <br /> maintain them on site. Provide a corrective action statement,a copy of the last three years of UW disposal records <br /> and supporting documentation to the San Joaquin County Environmental Health Department(EHD)within 30 days. <br /> This is a repeat violation, Class It. <br /> Overall Inspection Comments: <br /> An inspection checklist was provided to the facility operator on the day of inspection. An amended report was <br /> provided on 11/15/2023. <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 amended inspection report(12/15/2023). <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: <br /> Daae: September 27,2023 Inspector: Inspector Phone: <br /> Printed Name and Title: MICHAEL SUSZYCKI,REHS (209)598-7001 <br /> Emailed to Angelica Cintora, Manager <br /> FA0026366 PRO546502 SC001 09/27/2023 <br /> EHD 22-01 Rev.12/06/2021 Page 8 of 8 Small Quantity Hazardous Waste Generator OIR <br /> 1868 E. Hazelton Avenue 1 Stockton,California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sigov.org/EHD <br />