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�.. San Joaquin County NEW <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 Address: Date: <br /> -L'E[ALN i-S li; :'j Y 0C , rzL. <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item # Remarks <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened <br /> release. <br /> The emergency response procedures were not submitted on CERS website . A business plan shall include the <br /> following emergency response procedures for a release or threatened release of hazardous materials, including, but <br /> not limited to, the following: <br /> - immediate notification of local emergency personnel and the Environmental Health Department (EHD) <br /> -procedures for the mitigation of a release or threatened release to minimize any potential harm or damage to <br /> persons, property, or the environment <br /> -evacuation plans and procedures, including immediate notice, for the site <br /> Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/, upload the <br /> correct or updated information, and submit to the EHD for approval. <br /> This is a Class II violation. <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility. <br /> A training program was not submitted on CERS website. Training programs for all employees and annual training, <br /> including refresher courses, shall include safety procedures for the event of a release or threatened release of a <br /> hazardous material, including, but not limited to, familiarity with the facility's emergency response plans and <br /> procedures. These training programs may take into consideration of each employee. Immediately prepare or update <br /> the facility's training program, log into the California Environmental Reporting System (CERS) at <br /> http://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. <br /> This is a Class II violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Coni; rice Certification form to the EHD with a statement <br /> documenting the corrective actions that have been or will be taken for each violation, and any supporting <br /> paperwork, by 4/16/2015 <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 /> your hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant <br /> activities and required fields. <br /> ALL EHD STAFF TIME ASSO IATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACIL TY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By Received By(printed name and title): Date: <br /> (signature): Eliseo De Santiago, manager <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): JAMIE DE LA ROSA, HM Specialist 11 (209) 953-6211 <br /> Page 3 of 3 <br />