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SAN JOAQUIN COUNTY <br /> N., ENVIRONMENTAL HEALTH DEPARTMEN., e <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 468-3433 Web:www.sioov.org/ehd/unitiii.html <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION REPORT <br /> Facility Facility - inspectio <br /> Name: Address: Date: _1 '— <br /> Facility Title: <br /> Contac[: PO <br /> Inspection Routi Follow up Complaint—ID#: Other: <br /> Type: <br /> (Authority HSC <br /> Consent for: nspedi Sampling Photos Granted by: Title: C <br /> FO <br /> VIOLATIONS <br /> If C1 C2 M Code Section HSC=California Health and Safety Code;CCR=California Code of Regulations <br /> C1 =Class 1 violation;C2=Class 2 violation;M=Minor violation <br /> 1 HSC 25505(e) Failed to maintain a complete copy of the business plan on site <br /> 2 CCR 2729.2(a)(1) Failed to complete and submit the Business Owner/Operator Identification information[HSC25509] <br /> 3 CCR 2729.2(a)(2) Failed to complete and submit the Hazardous Materials—Chemical description information[HSC 25509] <br /> 4 CCR 2729.2(a)(3) Failed to complete and submit an Annotated Site map[HSC 255091 <br /> 5 CCR 2731 Failed to include emergency response procedures for a release or threatened release of hazardous materials <br /> HSC 25504(b)] <br /> Failed to include a training program that includes at minimum:(1)safe handling of hazardous materials;(2) <br /> 6 CCR 2732(a) procedure for coordination with local emergency response organizations; (3)use of emergency equipment <br /> and supplies;and 4 emergency response procedures HSC 25504(c)] <br /> 7 CCR 2732(b) Failed to provide initial and/or refresher training to appropriate personnel[HSC 25504(c)] <br /> 8 CCR 2703 Failed to verbally report a release or threatened release immediately to the Environmental Health Department <br /> EHD and/or the California Emergency Management Agency CaIEMA HSC 25507(a)] <br /> 9 HSC 25505(b) Failed to update and submit revisions to the business plan when substantial changes occur <br /> 999 Other: See attached"Continuation—Official Inspection Report"for violation(s)not listed above. <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II, or MINOR-Notice to Comply) <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> lr.P MOf. Phone: <br /> e 7_c�q-tet 3- l <br /> Received by Tdle: <br /> EHD 19-01 Page 1 HM OFFICIAL INSPECTION REPORT <br /> 8/2/12 <br />