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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.ora/ehd <br /> Hazardous Materials Program Inspection Report <br /> Facility Name: Facility Address: Date: <br /> COLLEGEVILLE MARKET & CAFL 13521 E MARIPOSA RD STOCKTON otember 16, 2015 <br /> SUMMARY OF VIOLATIONS <br /> (CLASS 1,CLASS II,or MINOR-Notice to Comply) <br /> Item# Remarks <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 uploaded to CERS website. A business plan shall include the following <br /> emergency response procedures for a release or threatened release of hazardous materials, including, but not limited <br /> to, the 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 II 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 uploaded to CERS website or available for inspection. Training programs for all employees <br /> and annual training, including refresher courses, shall include safety procedures for the event of a release or <br /> threatened release of a hazardous material, including, but not limited to, familiarity with the facility's emergency <br /> response plans and procedures. These training programs may take into consideration of each employee. <br /> Immediately prepare or update the facility's training program, log into the California Environmental Reporting System <br /> (CERS) at http://cers.calepa.ca.gov/, upload the correct or updated information, and submit to the EHD for approval. <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 10/16/2015 <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 T MPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACIL IS SUBJECT TO REINSPECTION AT ANYTIME AT EHD'S CURRENT HOURLY RATE. <br /> Received By Received By(printed name and title): Data: 1 <br /> (signature): Philip Mathews, Manager Cq 6\ <br /> Inspector Inspector(printed name and title): Inspector Phone: <br /> (signature): JAMIE DE LA ROSA, HM Specialist II (209) 953-6211 <br /> Page 3 of 3 <br />