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San Joaquin County ti <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 /> GDGNALDS #jJ i U RD. <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 completed in CERS. The site map does not indicate the location of the Carbon L oxide tank. A <br /> site map shall contain a north orientation, loading areas, internal roads, adjacent streets, storm and sewer drains, <br /> access and exit points, emergency shutoffs, evacuation staging areas, hazardous material handling and storage <br /> areas, and emergency response equipment. Immediately log into the California Environmental Reporting System <br /> (CERS) at hftp://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. <br /> This is a minor 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 4/19/2015. <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 ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received ByReceived By(printed name and title): Date: <br /> (signature): Kathy Karus, Area Supervisor ZO /5 <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): J HAZA SAEED, HM Specialist 1 (209) 953-6212 <br /> Page 2 of 2 <br />