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we San Joaquin County 9171 9690 0935 0084 8438 35 Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone:(209) 468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd Hazardous Materials Program Inspection Report Facility Name: Facility Phone: Date: PERKOS CAFE (209) 832-4675 July 27, 2015 Facility Address: CERS ID: 1321 W ELEVENTH ST, TRACY, CA 95376 0 Inspection Contact: Title: Phone: Kim Montoya Manager 1 .1) 832-4675 Inspection Type: Program: ROUTINE INSPECTION -Operating Permit 1921 - HMBP-Regular-Primary Location Consent For: Consent Given By: O Inspection N Photos ❑ Samples I Kim Montoya, Manager CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspectio Violations 1 HSC 25507 Failed to establish and implement a hazardous materials business plan ■V ❑R �COS 2 HSC 25508(a)(1) Failed to electronically submit a business plan mV ❑R ❑COS 3 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date ■V ❑R ❑COS 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program ❑V ❑R ❑COS 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center ❑V ❑R ❑COS 6 HSC 2551 Failed to complete and/or submit the Business Activities or Owner/Operator Identification page ■V ❑R ❑COS 7 HSC 25501 Failed to complete and/or submit hazardous materials inventory for all reportable materials on site ■V ❑R ❑COS 8 HSC 25508.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info or inventory ❑V ❑R ❑COS 9 HSC 25508.1(1) Failed to submit revisions to HMBP within 30 days of substantial change in operations ❑V ❑R ❑COS 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required content ■V ❑R ❑COS 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release ■V ❑R ❑COS 12 HSC 2551 Failed to submit a training program or program is not reasonable or adequate for facility ■V ❑R ❑COS 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel ■V ❑R ❑COS 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑V ❑R ❑COS 15 HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements ❑V ❑R ❑COS 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions ❑V in R ❑COS 17 HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R in COS 1010 See below Unlisted Administration/Documentation violation c V ❑R ❑COS 1040 See below Unlisted Release/Leaks/Spills violation n V 7 R o COS SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks Received by Inspector: Phone: Date: (initial): PETER LOMBARDI, HM Specialist 1 (209) 953-6213 07/27/2015 Page 1 of 4