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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, Califomia 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sacehd.com EHD 19-01 REV 07/26/16 Page 1 HM INSPECTION REPORT HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT Facility Name: F_ -c Facility Phone(iv Ct'f?-/S00 Inspecti n Date: Zq Facility- Address:41�6E /1, {� l�C. , - � �N-'f V cis CERS ID: All. t Inspection Contact: C�n V v C` t o Is: 0 t t3 vl e,- phone; ('LO'?) q37-10-13 Inspection Type: pnogrann: Consent Given For. D Inspection D Photos D Sampling Consent // Given By: Ckr CCR = California Code of — Regulations HSC = Health and Safety Code CFR =Code of Federal Regul tions ELI =San Joaquin County Ordinance V = Violation R = Repeat COS = Corrected on site dud in 'on Violations V R COS 1 SJO 4432 Failed to pay annual operating fees (V851) ❑ ❑ ❑ 2 HSC 25505, 25508 e 1 Failed to complete and electronically submit a hazardous materials business plan (V335) ii ❑ ❑ 3 HSC 25507 Failed to establish and implement a hazardous materials business plan (V334) ❑ ❑ 4 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page (V345) A ❑ ❑ 5 HSC 25506(a) Failed to complete and/or submit hazardous materials Inventory for all reportable materials on site (V343) pC ❑ ❑ 6 HSC 25505(x)(3) Failed to complete and/or submit a site map with all required content (V347) ❑❑ 7 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release wmel ❑ ❑ 8 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility (V350) X ❑ ❑ 9 HSC 25508.2 Failed to annually review and certify that the business plan is complete, accurate, and up to date (V342) 1t ❑ ❑ L. 10 HSC 255DBA (a -t) Failed to submit revisions to HMBP within 30 days of substantial change in operations (V346) ❑ ❑ ❑ 11 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel (V349) )r( ❑ 12 HSC 25505(c) Failed to have the business plan readily available to facility or EHD personnel (V850) X( ❑ ❑ 13 HSC 25505.1 Failed to notify properly owner that facility is subject to and in compliance with the HMBP program (V341) ❑ ❑ o 14 HSC 25510 Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center (V338) ❑ ❑ ❑ 15 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements (351) ❑ ❑ ❑ 16 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements (V352) ❑ ❑ ❑ 17 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions (V353) ❑ ❑ ❑ 18 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report (V808) ❑ ❑ ❑ 1010 See below Unlisted Administration/Documentation violation (V355) ❑ ❑ ❑ 1040 See below Unlisted Release/LeaWSpilis violation (V356) ❑ ❑ ❑ SUMMARY OF VIOLATIONS CLASS I, CLASS II, or MINOR — Notice to Comply (( is �Q Qc x.610 o d� e ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. THIS FAC41,ITY IS SUBJECT TO INSPECTION AT ANYTIME AT END'S CURRENT HOURLY RATE. Received by (signaW 1 Title:� ab Oy t T Dat Received by (printed name): )--)L)15fer,L Ins r. ,� t,,,z Inspector pnoone�: -2�1 1 `67-62i�4 EHD 19-01 REV 07/26/16 Page 1 HM INSPECTION REPORT