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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.siaov.org/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> SUMMARY OF VIOLATIONS <br /> (CLASS I,CLASS 11,or MINOR-Notice to Comply) <br /> Item# Remarks <br /> HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel. <br /> mployee tral ,vere nc ✓ailable _ time o` _ pection. Th. _Isiness plan shall include <br /> provisions for ensuring that appropriate personnel receive initial and annual refresher training. This training shall be <br /> documented electronically or by hard copy and shall be made available for a minimum of three years. Immediately <br /> provide employee training for appropriate personnel and submit a copy of the training records to the EHD. <br /> This is a Class II 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 <br /> paperwork, by 9/9/2015 . <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 HD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED ATTHE CURRENT HOURLY RATE. <br /> IffFA IS SUBJECT TO REINSPECTION ATANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By Received By(printed name and title): Date(signature): o <br /> Inspector / Inspector(printed name and title): Insp6ctof PWne: <br /> (signature): <br /> Page 3 of 3 <br />