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FAoaO;L5yS *05-qC)3" SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue,Stockton,California 95205-6232 Telephone.(209)468-3420 Fax;(209)468-3433 Web.wwvv sicehd.com H'�T':DOU IVI �T�ER AL P.R�GR�A'dIi11�SP-CTION f�EPO+T Facility Facility Inspection Name: A FE Phone: 20q-9>30-J1675 oats: 7-a-`7-1 S Faclity I '� / Y C A GOERS Address: W � 1—�CN rl Inspection Title. Phone: Contact' J A P�'v W lSt r� t — Inspection Program:Type: or P,) /9�l Consent Given For. Consent wfnspection wPhotos ii Sampling riven By: I tA moi—rmyA CCR=California Code of Regulations HSC=Health and Safety Coe CFR=Code of Federal Regulations V=Violation R=Repeat COS=Corrected on site during inspection 1 HSC 25507 Failed to establish and implement hazardous materials business plan(V334) ❑ ❑ 2 HSC 25508(a)(1) Failed to electronically submit a business plan(V335) Girl ❑ ❑ 3 HSC 25508.2 Failed to annually review and certify that the business plan is complete,accurate,and up to date(V342) ❑ ❑ 4 HSC 25505.1 Failed to notify property owner that facility,is subject to and in compliance with the HMBP program(V341) ❑ ❑ ❑ 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CaIOES Warning Center(V338) ❑ ❑ ❑ 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or OwnerlOpemtor Identification page(V346) 01 ❑ ❑ 7 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site(V343) ❑ ❑ 6 HSC 26608.1(a)-(e) Failed to submit revisions to HMBP within 30 days of change in business info or inventory(V346) ❑ ❑ ❑ 9 HSC 25508.1(1) Failed to submit revisions to HMBP within 30 days of substantial change in operations(V344) ❑ ❑ ❑ 10 HSC 25505(a)(2) Failed to complete andlor submit a site map with all required content 347) ❑ ❑ 11 HSC 25505(a)(3) Failed to establish andlor submit emergency response procedures for a release or threatened release rvxet ❑ ❑ 12 HSC 25505(a)(4) Failed to submit a training program or program Is not reasonable or adequate for facility(V350) ❑ ❑ 13 HSC 25505(a)(4) Failed to provide or document initial andlor refresher training to appropriate personnel(V349) ❑ ❑ 14 HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements(351) ❑ ❑ ❑ 15 HSC 25507.1 Failed to submit training program when not meeting A9 handler exemption requirements(V352) ❑ ❑ ❑ 16 HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions(V353) ❑ ❑ ❑ 17 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 ReleaselLeakslSpills violation(V356) ❑ ❑ ❑ a.,(C_LASSUM SRII o�OF INOR MNS .: r OR Notice J 1sDS o e .c- ? i,�, @7'i .S I Te f-I 6 J-f S 17r ALL EHD STAFF TIME ASSOCIATED IMTH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. Received b (signature): Title: Date: M()NA(�-% `7 -7 -/S y(p'nte name): Inspector. Inspector phone: Kitl.A rno,IXTM/A 'pr--i Ej-2 l -(5rA(6A2p1 �'-09-g53'6a �3 E D 19-01 REV 04/23/15 Page 1 HM INSPECTION REPORT