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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.sogov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: ' <br /> Phone: Date: <br /> LAKEWOOD CHEVRON 209 333-6303 December 01, 2015 <br /> Facility Address: CERS ID: <br /> 236 N HAM LN LODI CA 95240 10181333 <br /> Inspection Contact: Title: Phone: <br /> Cath Huber Cashier 209 333-6303 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION -Operating Permit 1921 HMBP-Re ular-Prima Location <br /> Consent For: Consent Given By: <br /> O Ins ection 19 Photos ❑ Samples I Cathy Huber Cashier <br /> CCR=California Code of Regulations HSC=Health and SafetyCode CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> Violations <br /> 1 HSC 25507 Failed to establish and implement a hazardous materials business plan o V ❑R ❑COS <br /> 2 HSC 25508(a)(1) Failed to electronically submit a business plan o V ❑R ❑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 o COS <br /> 4 HSC 25505.1 Failed to notify property owner that facility is subject to and in compliance with the HMBP program ❑V o R ❑COS <br /> 5 HSC 25510 Failed to report actual or threatened release to the EHD and/or CalOES Warning Center o V ❑R o COS <br /> 6 HSC 25508(a)(1) Failed to complete and/or submit the Business Activities or Owner/Operator Identification page o V in R ❑COS <br /> 7 HSC 25506(a) Failed to complete and/or submit hazardous materials inventory for all reportable materials on site ❑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 in 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 ❑R o COS <br /> 11 HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release ❑V o R ❑COS <br /> 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility o 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 o COS <br /> L14HSC 25507.1 Failed to submit emergency response plan when not meeting Ag handler exemption requirements ❑V ❑R ❑COS <br /> HSC 25507.1 Failed to submit training program when not meeting Ag handler exemption requirements ❑V ❑R ❑COS <br /> HSC 25507.2 Failed to establish and implement a HMBP when not meeting remote unstaffed facility exemptions ❑V o R ❑COS <br /> HSC 25511 Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS <br /> See below Unlisted Administration/Documentation violation ❑V ❑R o COS <br /> See below Unlisted Release/Leaks/Spills violation o V ❑R o COS <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS Il,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> No violations noted at time of inspection. <br /> Received by Inspector: Phone: Date: <br /> (initial): JAMIE DE LA ROSA, HM Specialist II (209) 953-6211 12/011201r <br /> Page 7 of 2 <br />