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Environmental Health Department Facility Name: LGS WELL PAD 3 Facility Address: 8246 E COLLIER , ACAMPO, CA 95220 Facility Phone: (209) 368-9277 Program: 1921 - HMBP-Regular-Primary Location Inspection Type: ROUTINE INSPECTION - Operating Permit Date: June 14, 2018 CERS ID: 10187799 Inspection Contact: Greg Clark Consent For: Consent Given By: Greg Clark, Compliance Manager Title: Compliance Manager Phone: () - T Inspection T Photos £ Samples Hazardous Materials Program Inspection Report R = Repeat violation COS = Corrected on site during inspectionV = Violation CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations Violations 1 □ V □ R □ COSFailed to pay annual operating feesSJO 4432 2 □ V □ R □ COSFailed to complete and electronically submit a hazardous materials business planHSC 25505, 25508(a) (1) 3 □ V □ R □ COSFailed to establish and implement a hazardous materials business planHSC 25507 4 □ V □ R □ COSFailed to complete and/or submit the Business Activities or Owner/Operator Identification pageHSC 25508(a)(1) 5 □ V □ R □ COSFailed to complete and/or submit hazardous materials inventory for all reportable materials on siteHSC 25506(a)(1) 6 □ V □ R □ COSFailed to complete and/or submit a site map with all required contentHSC 25505(a)(2) 7 □ V □ R □ COSFailed to establish and/or submit emergency response procedures for a release or threatened releaseHSC 25505(a)(3) 8 □ V □ R □ COSFailed to submit a training program or program is not reasonable or adequate for facilityHSC 25505(a)(4) 9 □ V □ R □ COSFailed to annually review and certify that the business plan is complete, accurate, and up to dateHSC 25508(a)(1) 10 □ V □ R □ COSFailed to submit revisions to business plan within 30 days of substantial change in operationsHSC 25508.1(a)-(f) 11 □ V □ R □ COSFailed to provide or document initial and/or refresher training to appropriate personnelHSC 25505(a)(4) 12 □ V □ R □ COSFailed to have the business plan readily available to facility or EHD personnelHSC 25505(c) 13 □ V □ R □ COSFailed to notify property owner that facility is subject to and in compliance with the HMBP programHSC 25505.1 14 □ V □ R □ COSBusiness on leased property failed to provide copy of HMBP w/in 5 days of request by property ownerHSC 25505.1 15 □ V □ R □ COSFailed to report actual or threatened release to the EHD and/or CalOES Warning CenterHSC 25510(a) 16 □ V □ R □ COSFailed to submit emergency response plan when not meeting Ag handler exemption requirementsHSC 25507.1 17 □ V □ R □ COSFailed to submit training program when not meeting Ag handler exemption requirementsHSC 25507.1 18 □ V □ R □ COSFailed to establish and implement a HMBP when not meeting remote unstaffed facility exemptionsHSC 25505, 25507.2 19 □ V □ R □ COSFailed to submit a written response within 30 days of receiving an inspection reportHSC 25511 1010 □ V □ R □ COSUnlisted Administration/Documentation violation See below 1020 □ V □ R □ COSUnlisted Training violation See below 1030 □ V □ R □ COSUnlisted Operations/Maintenance violation See below 1040 □ V □ R □ COSUnlisted Release/Leaks/Spills violation See below 1045 □ V □ R □ COSUnlisted Release/Leaks/Spills - Local Ordinance See below 1050 □ V □ R □ COSUnlisted Abandonment/Illegal Disposal/Unauthorized Treatment violation See below 1055 □ V □ R □ COSUnlisted Abandonment/Illegal Disposal/Unauthorized Treatment - Local Ordinance See below SUMMARY OF VIOLATIONS (CLASS I, CLASS II, or MINOR - Notice to Comply) Page 1 of 2 FA0021351 PR0537189 SC001 06/14/2018 EHD 19-01 Rev. 10/31/2017 Hazardous Materials Program OIR 1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com