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San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209)468-3420 Fax:(209) 468-3433 Web:www.sigov.org/ehd Hazardous Materials Program Inspection Report Facility Name: Facility Address: Date: JACK IN max. #534 2592 MARCH LN, STOCKTON Ma 13. 24`` SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item # Remarks HSC 25505(a)(3) Failed to establish and/or submit emergency response procedures for a release or threatened release. At the time of inspection the emergency response procedures were not submitted. A business plan shall include the following emergency response procedures for a release or threatened release of hazardous materials, including, but not limited to, the following: - immediate notification of local emergency personnel and the Environmental Health Department (EHD) - procedures for the mitigation of a release or threatened release to minimize any potential harm or damage to persons, property, or the environment - evacuation plans and procedures, including immediate notice, for the site Immediately log into the California Environmental Reporting System(CERS) at http://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. This is a Class 11 violation. 12 HSC 25505(a)(4) Failed to submit a training program or program is not reasonable or adequate for facility. At the time of inspection a training program was not submitted. Training programs for all employees and annual training, including refresher courses, shall include safety procedures for the event of a release or threatened release of a hazardous material, including. but not limited to, familiarity with the facility's emergency response plans and procedures. These training programs may take into consideration of each employee. Immediately prepare or update the facility's training program, log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. This is a Class II violation. 13 HSC 25505(a)(4) Failed to provide or document initial and/or refresher training to appropriate personnel. At the time of inspection training records where not available for review. The business plan shall include provisions for ensuring that appropriate personnel receive initial and annual refresher training. This training shall be documented electronically or by hard copy and shall be made available for a minimum of three years. Immediately provide employee training for appropriate personnel and submit a copy of the training records to the EHD. This is a Class II violation. Overall Inspection Comments: Complete and submit a copy of the Return to Compliance Certification form to the EHD with a statement documenting the corrective actions that have been or will be taken for each violation, and any supporting paperwork, by 06142015 Please be aware as of January 1, 2013, all businesses are required to submit all hazardous materials information online to the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov. Be sure to include your hazardous material activity in the Businesses Activities section in CERS in addition to any other relevant activities and required fields. Received by Inspector: Phone: Date: (initial): PETER LOMBARDI, HM Spc—I«t ! Q - 05/13/2015 Page 3 of 4