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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.sigov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> JACK IN THE BOX#565 3506 W HAMMER LN, STOCKTON July 28, 2015 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> 10 HSC 25505(a)(2) Failed to complete and/or submit a site map with all required Content. <br /> A site map was not submitted as part of the business plan. A site map shall contain a north orientation, loading <br /> areas, internal roads, adjacent streets, storm and sewer drains, access and exit points, emergency shutoffs, <br /> evacuation staging areas, hazardous material handling and storage areas, and emergency response equipment. <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 minor violation. <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. A business plan shall include the following emergency <br /> response procedures for a release or threatened release of hazardous materials, including, but not limited to,the <br /> 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 11 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 at the time of inspection. Training programs for all employees and annual <br /> training, including refresher courses, shall include safety procedures for the event of a release or threatened release <br /> of a 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 <br /> update the facility's training program, log into the California Environmental Reporting System(CERS) at <br /> http://cers.calepa.r-a.gov/, upload the correct or updated information, and submit to the EHD for approval. <br /> This is a Class 11 violation. <br /> Overall Inspection Comments: <br /> Complete and submit a copy of the Return to Compliance 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 papetwol <br /> by August 29th,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 yol <br /> hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant activities <br /> and required fields. <br /> Received Inspector: Phone: Date: <br /> (initial): PETER LOMBARDI, HM Specialist I (209) 953-6213 07/28/2015 <br /> Page 3 of 4 <br />