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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209)468-3420 Fax:(209) 468-3433 Web:www.sjgov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> 7-ELEVEN INC#20632 209 952-3543 November 06 2015 <br /> Facility Address: CERS ID: <br /> 4627 DA VINCI DR Stockton CA 95207 10165883 <br /> Inspection Contact: Title: Phone: <br /> Mazhar Hussien Store Mana er <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION - O eratin Per 1921 - HMBP-Regular-Primary Location <br /> Consent For: Consent Given By: <br /> ❑x Inspection 0 Photos ❑ Sam as Mazhar Hussien Store Manager <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Conected on site during inspection <br /> Violations <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan u V n R ❑COS <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan o V ❑R o COS <br /> 3 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date ❑V ❑R ❑COS <br /> 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program ❑V ❑R ❑COS <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center n V ❑R ❑COS <br /> 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page ❑V ❑R ❑COS <br /> 7 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site o V ❑R ❑COS <br /> 8 HSC 25508.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info or inventory o V ❑R ❑COS <br /> 9 HSC 25508.1(f) Failed to submit revisions to HMBP within 30 days of substantial change in operations ❑V ❑R ❑COS <br /> 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content ❑V u R ❑COS <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release ❑V ❑R ❑COS <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility n V ❑R o COS <br /> 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel ❑V ❑R ❑COS <br /> 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑V ❑R o COS <br /> 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements o V n R n COS <br /> 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions ❑V ❑R ❑COS <br /> 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS <br /> 1010 See below Unlisted Administration/Documentation violation o V o R n COS <br /> 1040 See below Unlisted Release/Leaks/Spills violation ❑V o R ❑COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> There were no violations at the time of the inspection. <br /> Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials information <br /> online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be sure to include <br /> Received by Inspector: Phone: Date: <br /> (initial): HAZA SAEED, HM Specialist I (209) 953-6212 11/06/2015 <br /> Pagel of 2 <br />